The association of ethnicity with the incidence of graft-versus-host disease (GVHD) and other clinical outcomes after transplantation is controversial. We compared the results of HLA-identical sibling bone marrow transplantations for leukemia, performed between 1990 and 1999, among different ethnic populations, including 562 Japanese, 829 white Americans, 71 African Americans, 195 Scandinavians, and 95 Irish. Results for adults and children were analyzed separately. Multivariate analyses of adult patients showed that white Americans, African Americans, and Irish cohorts were at significantly higher risk for acute GVHD than Japanese or Scandinavian cohorts (relative risk [RR] ‫؍‬ 1.77, P < .001; RR ‫؍‬ 1.84, P < .006; RR ‫؍‬ 2.22, P < .001, respectively). White Americans, African Americans, and Irish, but not Scandinavians, were at significantly higher risk for early (within 3 months of transplantation) transplant-related mortality (TRM) compared with Japanese (RR ‫؍‬ 2.99, P < .001; RR ‫؍‬ 5.88, P < .001; RR ‫؍‬ 2.66, P < .009, respectively). No differences in the risk for chronic GVHD, relapse, and overall survival were noted. In the pediatric cohort (limited to Japanese and white Americans), white Americans were at significantly higher risk for acute (RR ‫؍‬ 1.93; P ‫؍‬ .04) and chronic (RR ‫؍‬ 3.16; P ‫؍‬ .002) GVHD. No differences in other clinical outcomes were noted. Our findings suggest that ethnicity may influence the risk for GVHD, though overall survival rates after transplantation remain similar.

The Japanese Red Cross analysed the results of questionnaires sent in 1993 regarding post-transfusion graft-vs.-host disease (PT-GVHD) from hospitals; the majority of patients with PT-GVHD in 1993 were transfused for cardiovascular or cancer surgery, and about 10 patients had died yearly from PT-GVHD in the following few years. The Japan Society of Blood Transfusion (JSBT) organized a subcommittee for the prevention of PT-GVHD, and issued a fourth version of guidelines for the irradiation of blood to prevent PT-GVHD. These guidelines recommended transfusion of irradiated blood for cardiosurgery, cancer surgery, elderly recipients and severe trauma, as well as congenital immunodeficient recipients, newborn infants and other immunocompromised patients. Also recommended was irradiation not only of blood within 72 h after collection but also of blood stored for 14 days. Reported PT-GVHD has diminished to a few cases in recent years.

No abstract

As a source of hematopoietic stem cells for transplantation, the use of peripheral blood stem cells (PBSCs) has become routine and comparable to that of the use of bone marrow. Recently, elderly patients with hematological malignancies also have been allowed to receive minitransplantations with nonmyeloablative conditioning regimens under sufficient PBSC infusion. As a result of these minitransplantations, elderly donors have been chosen increasingly from the siblings of elderly patients. We analyzed factors influencing the condition of CD34+ cells in the first days of collection in 49 healthy donors from July 1995 to January 2001. The median dose of recombinant human granulocyte colony-stimulating factor was 8 g/kg/day (range 8 ∼ 10) over 3 days. The target number of CD34+ cells used in this study was м 3 × 10 6 cells/kg of recipient body weight. The median apheresis volume was 12 L. Except for one 60 year old man, we obtained an adequate number of stem cells. In the regression analysis, a negative correlation was seen between donor age and the number of CD34+ cells/kg of recipient body weight per 12 L volume (Y ‫ס‬ aX + b; a ‫ס‬ −0.07507; b ‫ס‬ 6.629996; r ‫ס‬ −0.50985; p ‫ס‬ 0.000252). Significantly higher apheresis results were obtained in donors younger than 45 years compared with donors 45 years old and older (p < 0.0227). There were no correlations among the number of CD34+ cells, donor body weight, and the number of leukocytes in peripheral blood on the first day of apheresis. Key Words: CD34 positive cells-Donor age-Peripheral blood stem cell.Peripheral blood stem cells (PBSCs) mobilized by granulocyte colony-stimulating factor (G-CSF) and collected by apheresis are increasingly being used along with bone marrow for transplantation (1-3). With regard to the use of PBSCs for allogeneic hematopoietic stem cell transplantation, additional issues must be considered, such as the safety of healthy donors during apheresis. The second that must be considered is the most appropriate schedule for PBSC mobilization and harvesting. In addition, the number of elderly donors has recently increased due to the widespread use of minitransplantation (4,5). There are various reports suggesting that donor age affects the yield of PBSCs (6-10) while at the same time there are reports suggesting the opposite (11)(12)(13). It is necessary to plan transplantations and PBSC harvests adequately. In an attempt to better understand the factors influencing the mobilization and collection of CD34+ cells in healthy donors, we have analyzed the yields of CD34+ cells from 49 donors. MATERIALS AND METHODS Donor characteristics and apheresisA total of 49 consecutive healthy donors were included in this study (23 men, 26 women) from July 1995 to January 2001. Written informed consent was obtained from every donor before they underwent the procedure. The donors who had complications (e.g., hypertension and hyperlipidemia) were excluded. Apheresis was performed through peripheral venous access for all donors. The median age of the subjects w...