Similar outcome after unrelated allogeneic peripheral blood stem cell transplantation compared with bone marrow in children and adolescents.
This study compares children and adolescents with hematological malignancies undergoing allogeneic stem cell transplantation (ASCT) with unrelated donors receiving either bone marrow (BM, n=39) or peripheral blood stem cells (PBSCs, n=35). Age and other characteristics were comparable in the two groups. All patients were given conventional conditioning and antithymocyte globulin (ATG). Graft-versus-host disease prophylaxis consisted of cyclosporine plus methotrexate or prednisolone. After PBSC, engraftment of neutrophils and platelets were more rapid. The incidences of acute and chronic graft-versus-host disease were similar in the two groups. In the two groups, other outcome variables, such as transplant-related mortality, overall survival, and relapse-free survival, were the same. Patients given BM tended to have more relapses (P=0.1) and patients given PBSC tended to have more incidences of infectious death. Four cases of EBV-lymphomas were found among patients receiving PBSC, whereas no case was seen in patients given BM (P=0.1). We found no differences in transplant-related mortality and survival in children and adolescents receiving BM or PBSC from unrelated donors. More rapid engraftment and a trend for less relapses in patients given PBSC grafts was noted.
Remberger
Mats
M
Centre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital, SE-141 86 Stockholm, Sweden. mats.remberger@ki.se
Ringdén
Olle
O
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D008727:Methotrexate