Allogeneic peripheral blood stem cell transplantation. Safety, hematologic recovery, kinetics, and complications.
BACKGROUND
Hematopoietic stem cell transplants are an accepted treatment for several malignant and nonmalignant hematologic diseases. Recently, the peripheral blood, after mobilization of stem cells with growth factors, has become the source of choice for hematopoietic stem cells. We report on a series of patients who received peripheral blood stem cell transplants at the Instituto Nacional de Cancerologia (INCAN) in Mexico City.


METHODS
Between May 1995 and December 1999, 33 patients received peripheral blood stem cell transplants to treat hematologic diseases. Sixty percent of our patients had chronic myelocytic leukemia (CML). All had a matched related donor. Patients were conditioned with one of five different conditioning regimens and subsequently received one of two different graft-vs.-host disease prophylaxis regimens. Stratified Wilcoxon rank-sum, chi square, and Mann-Whitney tests were used to analyze the results.


RESULTS
In our series, median time to achieve a total neutrophil count of 0.5 x 10(9)/L was 14 days and to achieve a platelet count of 20 x 10(9)/L, 15 days. Acute graft-vs.-host disease occurred in seven patients. Chronic graft-vs.-host disease occurred in 69% of surviving patients. Survival for low-risk patients was 67% and for the high-risk group, 9%.


CONCLUSIONS
Peripheral blood stem cells produce a faster hematopoietic recovery. The rate of acute graft-vs.-host disease is not increased using the peripheral blood as source of stem cells; however, chronic graft-vs.-host disease continues to be a significant problem. Donors tolerated the procurement procedure without complications.
Sobrevilla-Calvo
Pedro
P
Departamento de Hematología, Instituto Nacional de Cancerología (INCAN), Av. San Fernando #22, Tlalpan, 14000 México City, D.F., México. pedrosc@mail.internet.com.mx
Rivas-Vera
Silvia
S
Cervera-Ubierna
Alfonso
A
López-P
Martha Patricia
MP
Acosta-Barreda
Aurora
A
Salles
Maria Teresa
MT
Marché-Cova
Alejandro
A
D000293:Adolescent; D000328:Adult; D002648:Child; D000075202:Contraindications; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous