title: Survival and freedom from progression in autotransplant lymphoma patients is independent of stem cell source: further follow-up from the original randomised study to assess engraftment.
abstract: Peripheral blood progenitor cells (PBPCs) have become the stem cell source of choice in autologous transplantation. In a prospective randomised trial, we previously demonstrated that autologous transplantation using filgrastim-mobilised PBPCs resulted in faster haematopoietic recovery with shorter hospitalisation and reduced platelet transfusions compared to bone marrow transplant (BMT). This study is a follow-up analysis evaluating the long-term clinical outcome. Seventy-two patients with advanced Hodgkin's disease or high-grade lymphoma were randomised to receive either filgrastim-mobilised PBPCs (n = 37) or bone marrow (n = 35) after BEAM chemotherapy. Fourteen patients withdrew from the study before commencing high-dose chemotherapy. Fourteen of the 58 patients who received treatment with chemotherapy and transplant have died, 6 (19%) in the ABMT arm and 8 (30%) in the PBPC transplant (PBPCT) arm. Twenty-five patients (81%) in the ABMT arm and 17 (63%) in the PBPCT arm, who received treatment, were in complete remission at the date of last follow-up. Progression-free survival and overall survival (OS) were similar for both arms (OS 81% at 46 months for ABMT versus 63% for PBPC; p = 0.38). Further prospective studies with larger number of patients need to be done to assess which source of stem cells may translate into a long-term clinical benefit for the patient.
authors: Department of Haematology, University College London Medical School, UK. p.kottaridis@ucl.ac.uk
authors: P D
authors: PD
authors: Kottaridis
authors: K
authors: K
authors: Peggs
authors: N
authors: N
authors: Schmitz
authors: P
authors: P
authors: Dreger
authors: M A
authors: MA
authors: Boogaerts
authors: A
authors: A
authors: Ferrant
authors: H M
authors: HM
authors: Demuynck
authors: A
authors: A
authors: Zander
authors: H
authors: H
authors: Link
authors: J
authors: J
authors: Matcham
authors: D C
authors: DC
authors: Linch
authors: K
authors: K
authors: Borkett
authors: A H
authors: AH
authors: Goldstone
mesh_terms: D000293:Adolescent; D000328:Adult; D001773:Blood Cells / Q000637:transplantation; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008223:Lymphoma / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000379:methods* / Q000401:mortality*; D016019:Survival Analysis; D014182:Transplantation, Autologous / Q000379:methods / Q000401:mortality