Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: The effect of donor age Journal Article


Authors: Kollman, C.; Howe, C. W. S.; Anasetti, C.; Antin, J. H.; Davies, S. M.; Filipovich, A. H.; Hegland, J.; Kamani, N.; Kernan, N. A.; King, R.; Ratanatharathorn, V.; Weisdorf, D.; Confer, D. L.
Article Title: Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: The effect of donor age
Abstract: The National Marrow Donor Program (NMDP) maintains a registry of approximately 4 million volunteer unrelated donors for patients in need of a stem cell transplant. When several comparably HLA-matched volunteers are identified for a patient, various criteria are used to select a donor. A retrospective analysis of 6978 bone marrow transplantations facilitated by the NMDP from 1987 to 1999 was conducted to study the effects of various donor characteristics on recipient outcome. The evaluation addressed possible effects of donor age, cytomegalovirus serologic status, ABO compatibility, race, sex, and parity on overall and disease-free survival, acute and chronic graft-versus-host disease (GVHD), engraftment, and relapse. Age was the only donor trait significantly associated with overall and disease-free survival. Five-year overall survival rates for recipients were 33%, 29%, and 25%, respectively, with donors aged 18 to 30 years, 31 to 45 years, and more than 45 years (P = .0002). A similar effect was observed among HLA-mismatched cases (28%, 22%, and 19%, respectively). A race mismatch between recipient and donor did not affect outcome. The cumulative incidences of grade III or IV acute GVHD were 30%, 34%, and 34%, respectively, with donors aged 18 to 30 years, 31 to 45 years, and more than 45 years (P = .005). The corresponding incidences of chronic GVHD at 2 years were 44%, 48%, and 49% (P = 0.02). Recipients with female donors who had undergone multiple pregnancies had a higher rate of chronic GVHD than recipients with male donors (54% versus 44%; P < .0001). The use of younger donors may lower the incidence of GVHD and improve survival after bone marrow transplantation. Age should be considered when selecting among comparably HLA-matched volunteer donors. © 2001 by The American Society of Hematology.
Keywords: adolescent; adult; cancer survival; child; aged; middle aged; survival rate; transplantation, homologous; incidence; risk factors; recurrence; age factors; retrospective study; age; disease severity; donor; register; registries; tissue donors; evaluation; infant; graft versus host reaction; outcomes research; pregnancy; sex difference; graft survival; gender; bone marrow transplantation; graft vs host disease; analysis of variance; continental population groups; histocompatibility; humans; human; male; female; priority journal; article
Journal Title: Blood
Volume: 98
Issue: 7
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2001-10-01
Start Page: 2043
End Page: 2051
Language: English
DOI: 10.1182/blood.V98.7.2043
PUBMED: 11567988
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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  1. Nancy Kernan
    512 Kernan