title: Long-term survival after transplantation of unrelated donor peripheral blood or bone marrow hematopoietic cells for hematologic malignancy.
abstract: We sought to determine whether differences in chronic graft-versus-host disease (GVHD) rates would lead to survival differences by comparing 2463 peripheral blood (PB) and 1713 bone marrow (BM) hematopoietic cell transplant recipients. Patients had acute leukemia, chronic myeloid leukemia (CML), or myelodysplastic syndrome, and they received myeloablative conditioning regimens and calcineurin-inhibitor GVHD prophylaxis. There were no significant differences in long-term survival after transplantation of PB and BM, except for patients in first chronic phase CML. For these patients, the 5-year rate of survival was lower after transplantation of PB compared with transplantation of BM (35% versus 56%, P = .001). Although mortality risks were higher in patients with chronic GVHD after both PB (hazard ratio [HR], 1.58; P < .001) and BM (HR 1.73; P < .001) transplantations, its effect on mortality did not differ by graft type (P = .42). BM is the preferred graft for first chronic phase CML, whereas as either graft is suitable for other leukemias.
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: meapen@mcw.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Fredrick R
authors.initials: FR
authors.lastname: Appelbaum
authors.affiliation: Center for Hematologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Antin
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Claudio
authors.initials: C
authors.lastname: Anasetti
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Couriel
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Junfang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.affiliation: Blood and Marrow Transplant Program, Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Department of Clinical Arrangements, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan; J.P. McCarthy Cord Stem Cell Bank, Detroit, Michigan.
authors.forename: Voravit
authors.initials: V
authors.lastname: Ratanatharathorn
authors.affiliation: Division of Hematology and Oncology, Washington University Medical School, St. Louis, Missouri.
authors.forename: Ravi
authors.initials: R
authors.lastname: Vij
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015456:Leukemia, Biphenotypic, Acute / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D016019:Survival Analysis; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors
chemical_list: D065095:Calcineurin Inhibitors; D019653:Myeloablative Agonists
keywords: Chronic graft-versus-host disease; Leukemia; Mortality