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Comparison of outcomes after transplantation of peripheral blood stem cells versus bone marrow following an identical nonmyeloablative conditioning regimen.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2007 Jul; Vol. 40 (1), pp. 19-27. Date of Electronic Publication: 2007 Apr 30. - Publication Year :
- 2007
-
Abstract
- This is the first study to examine the outcomes in 54 patients with hematologic malignancies who received an HLA-matched related donor bone marrow (BM, n = 42) or GCSF-mobilized peripheral blood stem cells (PBSC, n = 12) following identical nonmyeloablative conditioning with the intention of induction of mixed chimerism (MC) followed by prophylactic donor leukocyte infusion (pDLI) to convert MC to full donor chimerism (FDC) and capture a graft-versus-tumor effect without clinical graft-versus-host disease (GVHD). Neutrophil and platelet recovery were faster and transfusion requirement was less in PBSC recipients (P < 0.05). A total of 48% of BMT recipients achieved FDC with a median conversion time of 84 days, including 13 following pDLI. In contrast, 83% (P = 0.04) in the PBSC group had spontaneous FDC at a median of 14 days, precluding the administration of pDLI. There was no significant difference in the incidences of acute or chronic GVHD, though the rates of chronic GVHD were considerably higher in PBSC group than in the BM group (6/7, 86% vs 10/24, 42%). CD4 and CD8 T-cell recovery was faster in PBSC recipients. In PBSC recipients, a higher number of CD34+ cells was associated with increased rates of severe, grade III-IV acute GVHD.
- Subjects :
- Adult
Family
Female
Granulocyte Colony-Stimulating Factor therapeutic use
Hematopoietic Stem Cell Mobilization methods
Histocompatibility Testing
Humans
Male
Middle Aged
Recurrence
Transplantation Chimera
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome
Bone Marrow Transplantation
Hematologic Neoplasms therapy
Stem Cell Transplantation
Transplantation Conditioning methods
Subjects
Details
- Language :
- English
- ISSN :
- 0268-3369
- Volume :
- 40
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 17468773
- Full Text :
- https://doi.org/10.1038/sj.bmt.1705688