Premium
Previous donor pregnancy as a risk factor for acute graft‐versus‐host disease in patients with aplastic anaemia treated by allogeneic marrow transplantation
Author(s) -
Flowers Mary E. D.,
Pepe Margaret Sullivan,
Longton Gary,
Doney Kristine C.,
Monroe Deborah,
Witherspoon Robert P.,
Sullivan Keith M.,
Storb Rainer
Publication year - 1990
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1990.tb06340.x
Subject(s) - medicine , graft versus host disease , pregnancy , risk factor , aplastic anemia , graft vs host reaction , transplantation , immunology , disease , bone marrow transplantation , surgery , bone marrow , biology , genetics
Summary To determine if previous donor pregnancies influence the development of acute graft‐versus‐host disease (GVHD) we evaluated data from 136 patients with aplastic anaemia greater than 15 years of age and given marrow grafts from HLA‐identical sibling donors. Of the 136 marrow donors, 30 were parous females (previous history of pregnancy), 30 were nulliparous females (no history of pregnancy or abortions), and 76 were males. The cumulative incidence of grade II‐IV GVHD was 57%, 21% and 46% for patients with parous, nulliparous and male donors, respectively. A multivariate analysis of the data confirmed that the risk of grade II‐IV acute GVHD was significantly increased among patients receiving marrow from parous females as compared to those from nulliparous females (relative risk = 2·5, P = 0·02). There was no statistically significant difference in the incidence of acute GVHD, however, between patients with parous donors and male donors (relative risk = 1·3, P = 0·26). Male patients given grafts from parous donors showed a higher incidence of acute GVHD (63%) than female patients (45%), though this difference was not statistically significant. The 5‐year probability of survival was 47% for patients with parous donors, 68% for patients with nulliparous donors and 70% for those with male donors. We confirm that prior donor pregnancy represents an important factor in selecting marrow donors or designing clinical protocols for GVHD prophylaxis.