title: A randomised, prospective comparison of allogeneic bone marrow and peripheral blood progenitor cell transplantation in the treatment of haematological malignancies.
abstract: We present the results of a prospective, randomised study comparing PBPC and BM focusing on engraftment, acute and chronic GVHD and survival. Forty patients with haematological malignancies received HLA-identical sibling BM (group A) or PBPC (group B). Evaluable patients were 19 (A) and 18 (B). Median age was 35 (17-56) in A and 29.5 (9-51) in B. Conditioning was mainly Bu-Cy2; GVHD prophylaxis was CSA-MTX. PBPC were harvested after 5 days of G-CSF 10 microg/kg/day. Median days for an ANC >0.5 x 10(9)/l was 18 (13-30) in A and 16 (11-25) in B (P = 0.10). Platelets >20 x 10(9)/l occurred at +17 (10-40) in A and +12 (9-36) in B (P = 0.01). The probability of > or =2 grade a-GVHD was 19% (A) and 27% (B) (P = 0.53). The probability of all grade c-GVHD was 70% with BM. In spite of the small number of patients in group B (PBPC), our data suggest the great majority of them will have c-GVHD (P = 0.08); extensive disease was present in 50 and 100%, respectively (P = 0.05). The estimates of overall survival for A and B at 1000 days are 51 and 47%, respectively (P = 0.67); DFS at 1000 days are 52 and 58%, respectively (P = 0.50). PBPC resulted in faster platelet engraftment. The incidence of acute and chronic GVHD was similar in both groups, but the severity of c-GVHD was higher with PBPC. No differences in survival and DFS have been observed to date.
authors.affiliation: Bone Marrow Transplantation Unit, State University of Campinas, SP, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Vigorito
authors.forename: W M
authors.initials: WM
authors.lastname: Azevedo
authors.forename: J F
authors.initials: JF
authors.lastname: Marques
authors.forename: A M
authors.initials: AM
authors.lastname: Azevedo
authors.forename: K A
authors.initials: KA
authors.lastname: Eid
authors.forename: F J
authors.initials: FJ
authors.lastname: Aranha
authors.forename: I
authors.initials: I
authors.lastname: Lorand-Metze
authors.forename: G B
authors.initials: GB
authors.lastname: Oliveira
authors.forename: M E
authors.initials: ME
authors.lastname: Correa
authors.forename: A R
authors.initials: AR
authors.lastname: Reis
authors.forename: E C
authors.initials: EC
authors.lastname: Miranda
authors.forename: C A
authors.initials: CA
authors.lastname: de Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous