A retrospective comparison of allogeneic peripheral blood stem cell versus bone marrow transplantation.
OBJECTIVE
Disease evolution depends in part on the source of transplanted cells. Therefore, we compared outcomes after allogeneic bone marrow (BM) and peripheral blood stem cell (PBSC) transplantation in patients who underwent transplant at Hospital das Clinicas of the Federal University of Minas Gerais, Brazil.


METHODS
We studied 364 patients who received allogeneic BM (n = 142) or PBSC transplantation (n = 222) between July 1995 and May 2005. The median age of the patients was 31 years (range, 3.1-58 years). Chronic myeloid leukemia was the predominant diagnosis (41.2%). A conditioning regimen with cyclosphosphamide and busulfan was used in 79.4% (n = 289) and graft-versus-host disease (GVHD) prophylaxis was cyclosporine/methotrexate in 95.9% (n = 349) of cases.


RESULTS
The patients in the PBSC group had faster neutrophil (P < .001) and platelet engraftment (P = .03) but increased rates of acute GVHD (P < .001) vs. those in the BM group. There was no significant difference between the groups in chronic GVHD, transplant-related mortality, relapse and survival rates.


CONCLUSIONS
Although allogeneic PBSC transplant results in a faster hematopoietic engraftment, there was an increase in acute GVHD. There was no clear benefit in relapse rate and no evidence that transplantation with PBSC benefits patient survival in our institution.
Bittencourt
Henrique
H
Internal Medicine Department, Hematopoietic Stem Cell Transplantation Unit/Hematology Division, Universidade Federal de Minas Gerais, Minas Gerais, Brazil. hebit@terra.com.br
Lopes
Monalisa
M
de Macedo
Antonio Vaz
AV
Teixeira
Elen Rose
ER
Gomes
Gabriel Gomes Sabido
GG
Ferreira
Galileu Galilei
GG
Amaral
Leandro
L
Soares
Priscila
P
Vieira
Mônica
M
Dusse
Luci Maria
LM
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology*; D006402:Hematologic Diseases / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D055815:Young Adult