Long-term outcome of allogeneic human leukocyte antigen-matched sibling-donor peripheral blood stem cell transplantation in leukaemia patients.
Between 1993 and July 2008, a total of 354 leukaemic patients received either allogeneic bone marrow transplantation (BMT) [n = 180] or peripheral blood stem cell transplantation (PBSCT) [n = 174] from human leukocyte antigen-matched sibling donors. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and methotrexate. When comparing with BMT group, patients in the PBSCT group received much higher nucleated cells and CD34+ cells, and had much faster recovery of the neutrophil and platelet counts. The probability of developing acute GVHD was slightly higher in PBSCT patients (P = 0.02). The probability of chronic GVHD (cGVHD) in PBSCT was much higher in PBSCT (70 +/- 5.4%, extensive 48 +/- 6.5%) than in BMT (25 +/- 4.7%, extensive 10 +/- 3.4%; P < 0.001). Chronic GVHD was associated with long-term impairment of life quality and decreased quality-adjusted survival. In standard-risk leukaemia, use of PBSCT was associated with higher cGVHD, transplant-related mortality and a trend for decreased overall survival. The results suggest that allogeneic PBSCT is associated with high incidence of cGVHD in Chinese patients and its long-term risk and benefit remains to be defined in early stage of leukaemia.
Tang
J L
JL
Department of Internal Medicine, National Taiwan University Hospital. tangntuh@gmail.com
Yao
M
M
Lu
M Y
MY
Ko
B S
BS
Lin
D T
DT
Lin
K H
KH
Chen
Y C
YC
D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology*; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011788:Quality of Life; D035781:Siblings; D017741:Survivors; D013624:Taiwan / Q000453:epidemiology; D013995:Time; D014184:Transplantation, Homologous / Q000009:adverse effects