Factors influencing overall survival and GvHD development after allogeneic hematopoietic stem cell transplantation – single centre experience

Česká verzia

Authors: M. Homolová ¹; E. Bojtárová ²; M. Kováčová ²; K. Klučková ¹; M. Suchánková ¹; M. Kušíková ²; M. Mistrík ²; I. Shawkatová ¹
Authors place of work: Imunologický ústav LF UK, Bratislava, Slovenská republika ¹; Klinika hematológie a transfuziológie LF UK, SZU a UN Bratislava, Slovenská republika ²
Published in the journal: Klin Onkol 2024; 38(2): 118-125
Category: Original Articles
doi: https://doi.org/10.48095/ccko2024118

Summary

Backgrounds: Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a substantial therapeutic procedure for the treatment of a wide spectrum of severe diseases. Despite advancements in treatment and supportive care, alloHSCT still carries a considerable mortality risk, primarily caused by graft-versus-host disease (GvHD). Our retrospective analysis aimed to identify the factors influencing overall survival and GvHD development in HLA-identical sibling alloHSCT. We have analyzed patients’ and donors’ age, AB0 compatibility, recipient-donor gender match, stem cell source, time from the diagnosis to alloHSCT, conditioning regimen type, GvHD prophylaxis, and relapse. Patients and methods: Our study included 96 patients (54 male, 42 female) who underwent HLA-identical sibling alloHSCT. The median follow-up was 64.5 months (range 1–218 months), and the median age of both recipients and donors was 34 years. Malignant hematological diseases were the most common indications for alloHSCT. Results: GvHD and its complications accounted for the highest number of deaths (N = 24; 46.2%), followed by relapse (N = 18; 34.6%). Acute GvHD developed in 30 patients (31.3%), while chronic GvHD occurred in 25 patients (26.0%), resulting in a total of 45 patients (46.9%) experiencing GvHD. Male recipients with female donors had significantly worse overall survival compared to other patients (P = 0.01; HR = 2.33). Overall survival was better in patients transplanted within 1 year from the diagnosis compared to those transplanted after 1 year (P = 0.03; HR = 1.93). No factor reached statistical significance regarding the impact on acute GvHD, chronic GvHD, or overall GvHD. Conclusion: We confirmed that sex mismatch, specifically in the case of a female donor and a male recipient, significantly negatively affects overall survival after alloHSCT. Additionally, overall survival is significantly shorter when the interval between the diagnosis and alloHSCT exceeds one year.

Keywords:

GVHD – overall survival – hematopoietic stem cell transplantation

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