Birth order and transplantation outcome in hla-identical sibling stem cell transplantation: An analysis on behalf of the center for international blood and marrow transplantation

Christiane Dobbelstein, Kwang Woo Ahn, Michael Haagenson, Gregory A. Hale, Jon J. van Rood, David Miklos, Edmund K. Waller, Stephen R. Spellman, Marcelo Fernandez-Vina, Arnold Ganser, Mahmoud Aljurf, Martin Bornhaeuser, Vikas Gupta, Susan R. Marino, Marilyn S. Pollack, Vijay Reddy, Matthias Eder, Stephanie J. Lee

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Allogeneic stem cell transplantation (SCT) is the most effective treatment option for many hematologic malignancies, but graft-versus-host disease (GVHD) remains a major cause of treatment failure. Along with well-established risk factors for transplantation outcomes, recent single-center studies have identified a birth order effect in HLA-identical sibling SCT, with lower rates of acute and chronic GVHD and improved overall survival when the donor is younger than the recipient. One hypothesized mechanism for this effect is microchimerism due to fetomaternal and transmaternal sibling cell trafficking during pregnancy as the donor is exposed to recipient antigens in utero. The aim of the present study was to validate previously reported single-center data in a large, multicenter cohort provided by the Center for International Blood and Marrow Transplantation. All adult and pediatric patients (n = 11,365) with a hematologic malignancy who underwent allogeneic SCT with a graft from an HLA-identical sibling donor between 1990 and 2007 were included. When donors were younger than recipients, there was a significantly lower rate of acute GVHD grade II-IV and chronic GVHD in children, as well as a lower rate of chronic GVHD in adolescents. However, the hypothesized overall positive effect of lower relapse and better survival when donors are younger than recipients was not observed. Our data suggest that if otherwise equally matched, a graft from a younger sibling may be superior to a graft from an older sibling for children and adolescents undergoing SCT.

Original languageEnglish (US)
Pages (from-to)741-745
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number5
DOIs
StatePublished - May 2013

Keywords

  • Donor
  • Hematopoietic stem cell transplantation graft-versus-host-disease
  • Microchimerism

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint

Dive into the research topics of 'Birth order and transplantation outcome in hla-identical sibling stem cell transplantation: An analysis on behalf of the center for international blood and marrow transplantation'. Together they form a unique fingerprint.

Cite this