title: Similar outcomes of peripheral blood stem cells vs. bone marrow for human leukocyte antigen-matched unrelated donor transplantation in adult patients with acute myeloid leukemia using risk-adapted graft-versus-host disease prophylaxis.
abstract: BACKGROUND
  In unrelated donor allogeneic stem cell transplantation (URD-SCT), most studies reported that peripheral blood stem cells (PBSC) resulted in higher incidence of acute and/or chronic graft-versus-host disease (GVHD) without survival benefits compared with bone marrow (BM). To overcome these shortcomings of PBSC, we have used a risk-adapted GVHD prophylaxis for patients that received HLA-matched URD-SCT, which was adding low-dose rabbit antithymocyte globulin (Thymoglobulin(®) , 1.25 mg/kg for 2 d) to conditioning in the transplants with PBSC and not BM.
  
  
  METHODS
  To determine whether this strategy is effective, we analyzed 115 adult patients with acute myeloid leukemia who received HLA-matched URD-SCT with PBSC (n = 70) or BM (n = 45) using our risk-adapted GVHD prophylaxis strategy.
  
  
  RESULTS
  The PBSC group showed faster neutrophil (11 d vs. 13 d; P < 0.01) and platelet (12 d vs. 18 d; P < 0.01) engraftment compared with the BM group. No difference was observed in the incidence of acute GVHD grade II-IV at 100 d (54.3% vs. 64.4%; P = 0.38) and chronic GVHD at 4 yr (65.1% vs. 60.0%; P = 0.83). Other outcomes including the incidence of relapse (30.8% vs. 31.2%; P = 0.53), non-relapse mortality (13.5% vs. 6.9%; P = 0.24), disease-free survival (55.7% vs. 61.9%; P = 0.68), and overall survival (62.2% vs. 63.2%; P = 0.96) at 4 yr were not significantly different.
  
  
  CONCLUSIONS
  Our risk-adapted GVHD prophylaxis strategy resulted in similar transplant outcomes including comparable incidence of GVHD between the PBSC and BM groups in HLA-matched URD-SCT.
authors: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Seung-Hwan
authors: SH
authors: Shin
authors: Jung-Ho
authors: JH
authors: Kim
authors: Young-Woo
authors: YW
authors: Jeon
authors: Jae-Ho
authors: JH
authors: Yoon
authors: Seung-Ah
authors: SA
authors: Yahng
authors: Sung-Eun
authors: SE
authors: Lee
authors: Byung-Sik
authors: BS
authors: Cho
authors: Ki-Sung
authors: KS
authors: Eom
authors: Yoo-Jin
authors: YJ
authors: Kim
authors: Seok
authors: S
authors: Lee
authors: Chang-Ki
authors: CK
authors: Min
authors: Seok-Goo
authors: SG
authors: Cho
authors: Dong-Wook
authors: DW
authors: Kim
authors: Jong-Wook
authors: JW
authors: Lee
authors: Woo-Sung
authors: WS
authors: Min
authors: Chong-Won
authors: CW
authors: Park
authors: Hee-Je
authors: HJ
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000276:immunology; D019172:Transplantation Conditioning; D055815:Young Adult
chemical_list: D006680:HLA Antigens
keywords: acute myeloid leukemia; rabbit antithymocyte globulin; stem cell source; unrelated allogeneic stem cell transplantation