Faster engraftment of neutrophils and platelets with peripheral blood stem cells from unrelated donors: a comparison with marrow transplantation.
Engraftment was achieved in 43/45 (95%) recipients of peripheral blood stem cells (PBSC) from HLA-compatible unrelated donors (n = 45), compared to all 45 patients in matched controls receiving bone marrow and 14/18 (78%) recipients of CD34-selected PBSC (P < 0.01). The time to reach ANC >0.5 x 10(9)/l was a median of 16 days in the PBSC and CD34 groups, compared to 20 days in the bone marrow controls (P < 0.001 vs PBSC). The time to reach platelets >50 x 10(9)/l was a median of 23 days in the PBSC group and 24 days in the CD34 group, which was significantly faster than 29 days in the bone marrow controls (P < 0.01). Acute GVHD grades II-IV developed in 30% in the PBSC group, 20% in the recipients of bone marrow and 18% in the CD34 group. The corresponding figures for chronic GVHD were 59%, 85% and 0% (P < 0.01) in the three groups, respectively. The probability of non-relapse death was 27% in the recipients of PBSC, 21% in the bone marrow controls and 60% in the CD34 group (NS). The 2-year leukaemia-free survival was 46% in the PBSC group, 41% in the bone marrow group and 25% in the CD34 group (NS).
Centre for Allogeneic Stem Cell Transplantation and Department of Clinical Immunology, Huddinge Hospital, Sweden.
O
O
Ringdén
M
M
Remberger
V
V
Runde
M
M
Bornhäuser
I W
IW
Blau
N
N
Basara
K
K
Hölig
D W
DW
Beelen
H
H
Hägglund
O
O
Basu
G
G
Ehninger
A A
AA
Fauser
D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000473:pathology*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D006085:Graft Survival; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000097:blood / Q000276:immunology / Q000628:therapy; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D013997:Time Factors; D014184:Transplantation, Homologous
D006680:HLA Antigens