Worse outcome and more chronic GVHD with peripheral blood progenitor cells than bone marrow in HLA-matched sibling donor transplants for young patients with severe acquired aplastic anemia.
We analyzed the outcome of 692 patients with severe aplastic anemia (SAA) receiving transplants from HLA-matched siblings. A total of 134 grafts were peripheral blood progenitor cell (PBPC) grafts, and 558 were bone marrow (BM) grafts. Rates of hematopoietic recovery and grades 2 to 4 chronic graft-versus-host disease (GVHD) were similar after PBPC and BM transplantations regardless of age at transplantation. In patients older than 20 years, chronic GVHD and overall mortality rates were similar after PBPC and BM transplantations. In patients younger than 20 years, rates of chronic GVHD (relative risk [RR] 2.82; P = .002) and overall mortality (RR 2.04; P = .024) were higher after transplantation of PBPCs than after transplantation of BM. In younger patients, the 5-year probabilities of overall survival were 73% and 85% after PBPC and BM transplantations, respectively. Corresponding probabilities for older patients were 52% and 64%. These data indicate that BM grafts are preferred to PBPC grafts in young patients undergoing HLA-matched sibling donor transplantation for SAA.
Schrezenmeier
Hubert
H
Institute of Clinical Transfusion Medicine and Immunogenetics, University of Ulm, Germany.
Passweg
Jakob R
JR
Marsh
Judith C W
JC
Bacigalupo
Andrea
A
Bredeson
Christopher N
CN
Bullorsky
Eduardo
E
Camitta
Bruce M
BM
Champlin
Richard E
RE
Gale
Robert Peter
RP
Fuhrer
Monika
M
Klein
John P
JP
Locasciulli
Anna
A
Oneto
Rosi
R
Schattenberg
Antonius V M B
AV
Socie
Gerard
G
Eapen
Mary
M
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D006680:HLA Antigens; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D035781:Siblings; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D006680:HLA Antigens