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.
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.
Kottaridis
P D
PD
Department of Haematology, University College London Medical School, UK. p.kottaridis@ucl.ac.uk
Peggs
K
K
Schmitz
N
N
Dreger
P
P
Boogaerts
M A
MA
Ferrant
A
A
Demuynck
H M
HM
Zander
A
A
Link
H
H
Matcham
J
J
Linch
D C
DC
Borkett
K
K
Goldstone
A H
AH
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