Deletion of Y chromosome before allogeneic hematopoietic stem cell transplantation in male recipients with female donors
| Autor: | Masaharu Tamaki, Kazuaki Kameda, Shun-ichi Kimura, Naonori Harada, Naoyuki Uchida, Noriko Doki, Masatsugu Tanaka, Kazuhiro Ikegame, Masashi Sawa, Yuta Katayama, Shigesaburo Miyakoshi, Takahide Ara, Junya Kanda, Makoto Onizuka, Takahiro Fukuda, Yoshiko Atsuta, Yoshinobu Kanda, Kimikazu Yakushijin, Hideki Nakasone |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Blood Advances. 6:1895-1903 |
| ISSN: | 2473-9537 2473-9529 |
| Popis: | The graft-versus-leukemia (GVL) effect is one of the curative mechanisms of allogeneic hematopoietic stem cell transplantation (allo-HCT). H-Y antigens, which are encoded by Y chromosome, are important targets of the GVL effect. Thus, deletion of the Y chromosome (del[Y]) might cause the GVL effect to deteriorate in a transplantation involving a female donor and male recipient, although the clinical significance of the del(Y) group remains to be elucidated. In this study, we evaluated adult male patients who underwent allo-HCT between 2010 and 2019 in Japan. There were 155 cases in the del(Y) group and 4149 cases without del(Y) who underwent female-to-male allo-HCT. Del(Y) was significantly associated with inferior overall survival (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.00-1.53; P = .049) and an increased risk of relapse (HR, 1.40; 95% CI, 1.08-1.80; P = .0098) in multivariate analyses. There was no significant difference in nonrelapse mortality between recipients with and without del(Y) (HR, 1.08; 95% CI, 0.769-1.51; P = .67). In contrast, del(Y) was not significantly associated with any clinical outcomes in the cohort of male-to-male allo-HCT. A higher incidence of relapse might have been caused by attenuation of the GVL effect resulting from a lack of H-Y antigens. Because a GVL effect resulting from sex mismatch may not be expected in men with del(Y) who undergo allo-HCT with a female donor, additional post–allo-HCT strategies might be required to prevent disease relapse. |
| Databáze: | OpenAIRE |
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