Peripheral blood stem cell transplantation compared with bone marrow transplantation from unrelated donors in patients with leukemia: a single institutional experience.
We analyzed data for 89 patients with leukemia undergoing bone marrow transplantation (BMT) (n=44) or peripheral blood stem cell transplantation (PBSCT) (n=45) from unrelated donors between May 2000 and February 2009 in our institution. PBSCT resulted in faster hematopoietic engraftment, compared with BMT (P<0.001). There was no difference between BMT and PBSCT in infectious episodes and CMV antigenemia within the first 100 days post-transplantation. The frequency of acute graft-versus-host disease (GVHD) grades II-IV was 49.7% and 47.0% (P=0.838) and of chronic GVHD 42.4% and 43.9% (P=0.827) in BMT and PBSCT. The 5-year cumulative percent of relapse was 18.5 in BMT and 48.6 in PBSCT (P=0.041), and the transplant-related mortality (TRM) was 40% and 29.5% (P=0.800), respectively. The 5-year cumulative percent of disease-free survival (DFS) was 50.8 and 38.9 (P=0.439); overall survival (OS) was 55.3% and 48.5% (P=0.447) in BMT and PBSCT, respectively. The reconstitution of T and B cells at 1, 3, 6, 9, and 12 months post-transplantation was not different between BMT and PBSCT, except that the level of regulatory T cells (T-regs) was higher after PBSCT than after BMT at 1 month (P=0.001).
Liu
Q-F
QF
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. liuqifa@fimmu.com.cn
Liu
C
C
Zhang
Y
Y
Sun
J
J
Yi
Z-S
ZS
Fan
Z-P
ZP
Xu
D
D
Jiang
Q-L
QL
Xu
X-J
XJ
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007239:Infections / Q000188:drug therapy; D007938:Leukemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D016019:Survival Analysis; D014019:Tissue Donors; D055815:Young Adult