Limited Impact of Donor-Recipient Weight Difference on Outcomes of Allogeneic Hematopoietic Cell Transplantation
Bibliographic record
Abstract
Donor-recipient weight difference may be an important consideration in selection of suitable donors in allogeneic hematopoietic cell transplantation (HCT), as it can affect stem cell yield during harvesting. However, the impact of donor-patient weight difference on transplant outcomes remains largely unknown. We retrospectively analyzed 841 consecutive patients transplanted at Princess Margaret Hospital 2018-2023. The majority of patients received HCT for acute myeloid leukaemia (48.3%) or myelodysplastic syndrome (16.9%) using matched unrelated (48.5%) or matched related (23.3%) donors. The median donor/recipient weight difference was 1.3 kg (range: -82-128). Weight difference was positively correlated with CD34+ cell dose (P<0.001). A Cox proportional hazard model including weight as a continuous variable demonstrated no impact of weight difference on survival, relapse, relapse-free survival (RFS), or non-relapse mortality (NRM). In contrast, the use of heavier donors was associated with a small but significant increase in the risk of cytomegalovirus (CMV) reactivation in univariate analysis (HR 1.06, P=0.02) and chronic graft-vs-host disease (GVHD) in univariate (HR 1.07, P=0.03) and multivariate (HR 1.07, P=0.04) analyses. Patients were then divided into three groups based on the donor-recipient weight difference: <-20kg (16.2%), -20-20kg (62.8%) and >20kg (21.1%). Weight difference was positively correlated with CD34+ cell dose (P<0.001). The use of heavier donors was associated with faster absolute neutrophil count (P=0.03) but not platelet (P=0.18) engraftment. There was no effect of donor-recipient weight difference on survival, relapse, RFS, NRM, grade 2-4 and 3-4 acute GVHD, chronic GVHD, moderate-severe cGVHD, incidence of blood stream infections at day 30, or Epstein-Barr virus reactivation at 1-y (Figure 1). The use of heavier donors remained associated with the incidence of CMV reactivation at 1-y. Our data suggest that donor-recipient weight discrepancy, although associated with risk of CMV reactivation and chronic GVHD, has little impact on other major outcomes post allogeneic HCT. Therefore, donor-recipient weight difference should be given limited consideration on donor selection in allogeneic HCT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".