Impact of Donor and Recipient Sex on Outcomes of HLA-Identical Sibling Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Allogeneic hematopoietic stem cell transplantation (SCT) may cure patients with hematologic malignancies, but it carries significant risks. Careful donor se-lection is an important component of the clinical transplantation decision-making process and includes evaluation of HLA typing and other criteria, the most controversial of which is sex.Male recipients of transplants from fe-male(F→M) hematopoietic stem cell donors represent a special group in whom donor T cells that are specific for recipient minor histocompatibility antigens encoded by Y-chromosome genes may contribute to graft-versus-host disease (GVHD). We examined the the effect of donor and recipient sex mis match on outcomes of HLA-identical sibling allogeneic stem cell transplantation in 83 patients who underwent HLA-identical sibling hematopoieic stem cell transplantation (HSCT) for hematopoietic malignancies. Wefound that: 1. there was an increased risk of acute GVHD in patients who received grafts from female donor. 2. female donors result in an increased risk of chronic graft-versus-host disease (GVHD). 3. male recipients with female donors had significantly reduced survival