title: Bone marrow compared with peripheral blood stem cells for haploidentical transplantation with a nonmyeloablative conditioning regimen and post-transplantation cyclophosphamide.
abstract: Recently, the administration of high-dose cyclophosphamide (Cy) after T cell-replete haploidentical stem cell infusion has been reported to be feasible and effective. In the original study, bone marrow (BM) was used as the source of stem cells. Here, we retrospectively analyzed the use of BM versus peripheral blood stem cells (PBSCs) in a cohort of patients receiving haploidentical T cell-replete transplantation after a nonmyeloablative conditioning regimen with postinfusion Cy. In the PBSC versus BM groups, the incidence of acute graft-versus-host disease (GVHD) was 33% versus 25%, respectively, and the incidence of chronic GVHD was 13% versus 13%, respectively. The median time to achieve a safe and unsupported absolute neutrophil and platelet count was 20 versus 21 days and 27 versus 29 days, respectively. The incidence of engraftment was also similar in the 2 cohorts. The 1-year nonrelapse mortality rate was 12% versus 22%, respectively (P = .96). Finally, nonsignificant differences in survival were observed. In conclusion, the use of PBSCs instead of BM after T cell-replete haploidentical transplantation did not appear to be detrimental in terms of either GVHD or engraftment rate. PBSCs could be a valid alternative to BM after transplantation from a haploidentical donor using postinfusion Cy.
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy. Electronic address: luca.castagna@cancercenter.humanitas.it.
authors: Luca
authors: L
authors: Castagna
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Roberto
authors: R
authors: Crocchiolo
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Sabine
authors: S
authors: Furst
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Stefania
authors: S
authors: Bramanti
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Jean
authors: J
authors: El Cheikh
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Barbara
authors: B
authors: Sarina
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Angela
authors: A
authors: Granata
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Elisa
authors: E
authors: Mauro
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Catherine
authors: C
authors: Faucher
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Bilal
authors: B
authors: Mohty
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France.
authors: Samia
authors: S
authors: Harbi
authors: Cell Therapy Unit, Institut Paoli Calmettes, Marseille, France; Aix-Marseille Université, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France.
authors: Christian
authors: C
authors: Chabannon
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Carmelo
authors: C
authors: Carlo-Stella
authors: Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy.
authors: Armando
authors: A
authors: Santoro
authors: Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France; Aix-Marseille Université, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France.
authors: Didier
authors: D
authors: Blaise
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000401:mortality / Q000473:pathology; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide
keywords: Haploidentical transplantation; Postinfusion cyclophosphamide; Stem cell sources