title: Similar outcome after unrelated allogeneic peripheral blood stem cell transplantation compared with bone marrow in children and adolescents.
abstract: 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.
authors: Centre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital, SE-141 86 Stockholm, Sweden. mats.remberger@ki.se
authors: Mats
authors: M
authors: Remberger
authors: Olle
authors: O
authors: Ringdén
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D008727:Methotrexate