title: Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: a propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry.
abstract: We retrospectively analyzed the results of 707 adult patients who underwent myeloablative peripheral blood stem cell transplantation (PBSCT) (n = 365) and myeloablative bone marrow transplantation (BMT) (n = 342) for leukemia from HLA-identical sibling donors between 2000 and 2005 using the propensity score method. The results were obtained from the Japan Society for Hematopoietic Cell Transplantation registry. Multivariate Cox analysis showed that PBSCT was associated with lower overall survival (OS) in standard-risk patients [adjusted hazard ratio (aHR) = 1.83; 95% confidence interval (CI) 1.04-3.23; P = 0.036], but not in high-risk patients (aHR = 1.11; 95% CI 0.76-1.61; P = 0.599). Hematopoietic recovery was significantly faster after PBSCT. The risk of acquiring grade III-IV acute graft-versus-host disease (GVHD) (aHR = 2.23; P = 0.040) and extensive chronic GVHD (aHR = 1.93; P = 0.001) were significantly higher after PBSCT. PBSCT was associated with higher non-relapse mortality in standard-risk patients (aHR = 2.30; 95% CI 1.08-4.88; P = 0.030), but not in high-risk patients (aHR = 1.29; 95% CI 0.65-2.54; P = 0.468). Relapse after transplantation did not differ between PBSCT and BMT either in standard-risk group or in high-risk group (aHR = 1.17; 95% CI 0.55-2.52; P = 0.684 and aHR = 0.81; 95% CI 0.52-1.28; P = 0.370, respectively). In this retrospective analysis, OS was significantly lower after PBSCT in standard-risk patients, but not in high-risk patients. PBSCT was associated with significant risks of grade III-IV acute GVHD and extensive chronic GVHD.
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. knagafuji@med.kurume-u.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Nagafuji
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hidaka
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kodera
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Atsuo
authors.initials: A
authors.lastname: Maruta
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yoshiba
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ichinohe
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kasai
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Takatsuka
authors.forename: Kohmei
authors.initials: K
authors.lastname: Kubo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sao
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuchida
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000473:pathology; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007564:Japan; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D057216:Propensity Score; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens
references.citation: J Clin Oncol. 2005 Aug 1;23(22):5074-87
references.pmid: 16051954
references.citation: Cancer. 2005 Apr 15;103(8):1652-8
references.pmid: 15742336
references.citation: Am J Med. 1980 Aug;69(2):204-17
references.pmid: 6996481
references.citation: Bone Marrow Transplant. 1995 Jun;15(6):825-8
references.pmid: 7581076
references.citation: N Engl J Med. 1979 May 10;300(19):1068-73
references.pmid: 34792
references.citation: Curr Opin Oncol. 2008 Mar;20(2):220-6
references.pmid: 18300773
references.citation: Am J Epidemiol. 1999 Aug 15;150(4):327-33
references.pmid: 10453808
references.citation: Blood. 2001 Dec 1;98(12):3186-91
references.pmid: 11719353
references.citation: Lancet. 2000 Apr 8;355(9211):1199-200
references.pmid: 10770296
references.citation: Blood. 2002 Sep 1;100(5):1525-31
references.pmid: 12176866
references.citation: N Engl J Med. 1981 Jun 18;304(25):1529-33
references.pmid: 7015133
references.citation: Blood. 1996 Oct 1;88(7):2794-800
references.pmid: 8839878
references.citation: Blood. 2002 Aug 1;100(3):761-7
references.pmid: 12130483
references.citation: J Clin Oncol. 2000 Feb;18(3):537-46
references.pmid: 10653869
references.citation: Bone Marrow Transplant. 1998 Dec;22(12):1145-51
references.pmid: 9894716
references.citation: N Engl J Med. 1998 Oct 22;339(17):1177-85
references.pmid: 9780337
references.citation: Blood. 1989 Nov 1;74(6):2252-6
references.pmid: 2804362
references.citation: Bone Marrow Transplant. 2000 Jun;25(11):1129-36
references.pmid: 10849524
references.citation: Stat Med. 1999 Mar 30;18(6):695-706
references.pmid: 10204198
references.citation: Blood. 2006 Dec 15;108(13):4288-90
references.pmid: 16946302
references.citation: J Clin Oncol. 2004 Dec 15;22(24):4872-80
references.pmid: 15520055
references.citation: Blood. 2008 Dec 1;112(12):4371-83
references.pmid: 19029455
references.citation: J Clin Oncol. 2001 Aug 15;19(16):3685-91
references.pmid: 11504750
references.citation: Cancer Chemother Rep. 1966 Mar;50(3):163-70
references.pmid: 5910392
references.citation: Blood. 2005 Feb 15;105(4):1408-16
references.pmid: 15486071
references.citation: Leukemia. 2004 May;18(5):1013-9
references.pmid: 15029208
references.citation: Bone Marrow Transplant. 1999 Aug;24(4):355-8
references.pmid: 10467322
references.citation: Lancet. 2000 Apr 8;355(9211):1231-7
references.pmid: 10770306
references.citation: N Engl J Med. 2001 Jan 18;344(3):175-81
references.pmid: 11172139
references.citation: Blood. 2001 Nov 15;98(10):2900-8
references.pmid: 11698269
references.citation: Br J Haematol. 2004 May;125(4):480-93
references.pmid: 15142119
references.citation: Exp Hematol. 2003 Oct;31(10):855-64
references.pmid: 14550800
references.citation: Blood. 1997 Oct 15;90(8):2931-8
references.pmid: 9376573
references.citation: Blood. 2000 Jun 15;95(12):3702-9
references.pmid: 10845900
references.citation: Best Pract Res Clin Haematol. 2007 Jun;20(2):265-80
references.pmid: 17448961
references.citation: Blood. 2002 Oct 1;100(7):2374-86
references.pmid: 12239145