Comparative analysis of clinical outcomes after allogeneic bone marrow transplantation versus peripheral blood stem cell transplantation from a related donor in Japanese patients.
A reduced incidence of graft versus host disease (GvHD) has been documented among Japanese allogeneic bone marrow transplantation (BMT) patients, as the Japanese are genetically more homogeneous than western populations. To clarify whether this ethnic difference affects the results of allogeneic peripheral blood stem cell transplantation (PBSCT), we conducted a nationwide survey to compare clinical outcomes of allogeneic PBSCT (n = 214) and BMT (n = 295) from a human leucocyte antigen-identical-related donor in Japanese patients. The cumulative incidence of grades II-IV acute GvHD was 37.4% for PBSCT and 32.0% for BMT. The cumulative incidence of extensive chronic GvHD at 1 year was significantly higher after PBSCT than BMT (42% vs. 27%; P < 0.01). The organ involvement patterns of GvHD were different between the two groups. By multivariate analyses, the incidence of chronic GvHD was significantly increased in PBSCT, whereas the stem cell source did not affect the incidence of acute GvHD, transplant-related mortality, relapse or survival. We concluded that Japanese PBSCT patients have an increased risk of chronic GvHD compared with BMT patients, but the incidence of acute GvHD was still lower than in western populations. Thus, the choice of haematopoietic stem cell source should be considered based on data for individual ethnic populations.
Tanimoto
Tetsuya E
TE
First Department of Internal Medicine (Medicine and Biosystemic Science), Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. tetanimot@yahoo.co.jp
Yamaguchi
Takuhiro
T
Tanaka
Yuji
Y
Saito
Akiko
A
Tajima
Kinuko
K
Karasuno
Takahiro
T
Kasai
Masanobu
M
Kishi
Kenji
K
Mori
Takehiko
T
Maseki
Nobuo
N
Morishima
Satoko
S
Miyakoshi
Shigesaburo
S
Kasai
Masaharu
M
Ohno
Yuju
Y
Kim
Sung-Won
SW
Numata
Akihiko
A
Kami
Masahiro
M
Takaue
Yoichi
Y
Mori
Shin-ichiro
S
Harada
Mine
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007564:Japan; D007938:Leukemia / Q000235:genetics / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000601:surgery / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012306:Risk; D014184:Transplantation, Homologous; D016896:Treatment Outcome