title: Intraosseous compared to intravenous infusion of allogeneic bone marrow.
abstract: Thirty-eight patients (> or = 18 years) receiving marrow transplants from HLA-identical or one antigen-mismatched related donors were randomized to intraosseous (i.o.) + intravenous (i.v.) (n = 10), i.o. (n = 8) or i.v. (n = 20) infusions of bone marrow. There were no significant differences in patient characteristics. PMN/l more than 0.5 x 10(9) occurred on days 19 (median), 20 and 18.5 in the i.o. + i.v., i.o. and i.v. groups, respectively. We found a significant reduction in the number of days on total parenteral nutrition (P = 0.03) and a tendency to a reduction in the number of days on antibiotics (P = 0.06) in the i.o. compared to the i.v. group. Bacteraemia did not occur in the i.o. group, but was seen in 30% of the i.v. group (NS). The incidences of acute and chronic graft-versus-host disease, transplantation-related mortality, relapse and patient survival rates were similar in the three groups. Five patients examined with bone marrow scintigraphy showed the same distribution of granulocytes in the bone marrow directly after transplantation and 3 weeks after transplantation, whether the bone marrow was given by the i.o. or by the i.v. route. We conclude that allogeneic bone marrow transplantation can safely be performed by i.o. infusion, but haematopoietic recovery is not improved.
authors.affiliation: Department of Transplantation Surgery, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Hägglund
authors.forename: O
authors.initials: O
authors.lastname: Ringdén
authors.forename: B
authors.initials: B
authors.lastname: Agren
authors.forename: L
authors.initials: L
authors.lastname: Wennberg
authors.forename: M
authors.initials: M
authors.lastname: Remberger
authors.forename: L
authors.initials: L
authors.lastname: Rundquist
authors.forename: B M
authors.initials: BM
authors.lastname: Svahn
authors.forename: P
authors.initials: P
authors.lastname: Aspelin
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000209:etiology; D001853:Bone Marrow / Q000000981:diagnostic imaging; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006410:Hematopoiesis; D006801:Humans; D007262:Infusions, Intravenous; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012449:Safety