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Allogeneic hematopoietic stem cell transplantation (SCT) may cure pa-tients with hematologic malignancies, but it carries significant risks. Careful do-nor selection is an important component of the clinical transplantation deci-sion-making process and includes evaluation of HLA typing and other criteria, the most controversial of which is sex .Male recipients of transplants from fe-male(F→M) hematopoietic stem cell donors represent a special group in whom donor T cells that are specific for recipient minor histocompatibility antigens encoded by Y-chromosome genes may contribute to graft-versus-host disease (GVHD). We examined the the effect of donor and recipient sex mis match on outcomes of HLA-identical sibling allogeneic stem cell transplantation in 83 patients who underwent HLA-identical sibling hematopoieic stem cell transplantation (HSCT) for hematopoietic malignancies. We found that:
1. there was an increased risk of acute GVHD in patients who received grafts from female donor.
2. female donors result in an increased risk of chronic graft-versus-host disease (GVHD).
3. male recipients with female donors had significantly reduced survival compared with all patient/donor sex combinations.
So Until the effects sex on immune system are better understood, it is appro-priate whenever possble to avoid female donors and to choose male donors for male recipients in HLA-identical related donor SCT.