title: Randomized trial of allogeneic related bone marrow transplantation versus peripheral blood stem cell transplantation for chronic myeloid leukemia.
abstract: Seventy-two chronic myeloid leukemia patients were enrolled as part of a larger randomized trial at 3 centers between March 1996 and July 2001 to undergo either HLA-matched related allogeneic bone marrow (BM) or filgrastim (granulocyte colony-stimulating factor)-mobilized peripheral blood stem cell (PBSC) transplantation. Forty patients received BM, and 32 patients received PBSCs. There was no statistically significant difference in the incidence of acute or chronic graft-versus-host disease (GVHD), overall survival, disease-free survival, or non-relapse-related mortality between patients receiving BM or PBSC transplants. The cumulative incidence of grade II to IV acute GVHD was 49% in BM and 55% in PBSC recipients ( P = .48). The cumulative incidence of clinical extensive chronic GVHD was 50% in BM and 59% in PBSC recipients ( P = .46). Among 62 chronic phase chronic myeloid leukemia patients, there was no significant difference in overall survival (87% versus 81%; P = .59), disease-free survival (80% versus 81%; P = .61), or non-relapse-related mortality (13% versus 19%; P = .60) by cell source (BM versus PBSCs). Among chronic phase patients, however, there was a trend toward a higher cumulative incidence of relapse at 3 years in BM recipients (7% versus 0%; P = .10) and a higher cumulative incidence of chronic GVHD in PBSC recipients (59% versus 40%; P = .11). The trend toward a higher relapse incidence in BM recipients persisted with a longer follow-up.
authors.affiliation: Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. voehler@u.washington.edu
authors.forename: Vivian G
authors.initials: VG
authors.lastname: Oehler
authors.forename: Jerald P
authors.initials: JP
authors.lastname: Radich
authors.forename: Barry
authors.initials: B
authors.lastname: Storer
authors.forename: Karl G
authors.initials: KG
authors.lastname: Blume
authors.forename: Thomas
authors.initials: T
authors.lastname: Chauncey
authors.forename: Reginald
authors.initials: R
authors.lastname: Clift
authors.forename: David S
authors.initials: DS
authors.lastname: Snyder
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
authors.forename: Mary E D
authors.initials: ME
authors.lastname: Flowers
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Guthrie
authors.forename: Robert S
authors.initials: RS
authors.lastname: Negrin
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Appelbaum
authors.forename: William
authors.initials: W
authors.lastname: Bensinger
mesh_terms: D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D006086:Graft vs Host Disease / Q000401:mortality; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D014184:Transplantation, Homologous