title: Comparison of bone marrow versus peripheral blood allogeneic hematopoietic stem cell transplantation for hematological malignancies in adults - a systematic review and meta-analysis.
abstract: It is still under debate whether bone marrow (BM) or peripheral blood (PB) should be the preferred stem cell source in adult patients undergoing allogeneic stem cell transplantation for hematological malignancies. After systematic literature search we identified nine randomised controlled trials comparing BM and PB as stem cell source from 2341 total hits. Meta-analysis involving 1521 patients showed a statistically significant reduction in overall and extensive chronic GvHD for patients transplanted with BM (HR 0.72; 95% CI 0.61 to 0.85 and HR 0.69; 95% CI 0.54 to 0.9), but no difference in overall and disease-free survival. In the related donor setting, data from two of eight studies demonstrated a significant increase of relapse incidence for BM (HR 2.73; 95% CI 1.47 to 5.08). This systematic review demonstrates that the current clinical standard to use peripheral blood stem cells instead of bone marrow for allo-SCT is not inferior with regard to the primary outcome overall survival.
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany. Electronic address: udo.holtick@uk-koeln.de.
authors.forename: Udo
authors.initials: U
authors.lastname: Holtick
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Albrecht
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Jens M
authors.initials: JM
authors.lastname: Chemnitz
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Theurich
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shimabukuro-Vornhagen
authors.affiliation: Cochrane Hematological Malignancies Group, Department I of Internal Medicine, University of Cologne, Cologne, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Skoetz
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
authors.affiliation: Department I of Internal Medicine, Stem Cell Transplantation Program, University of Cologne, Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: von Bergwelt-Baildon
mesh_terms: D000328:Adult; D000367:Age Factors; D001792:Blood Platelets; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D006412:Hematopoietic Stem Cells; D006801:Humans; D009504:Neutrophils; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: Allogeneic stem cell transplantation; Bone marrow; Graft versus host disease; Peripheral blood; Stem cell source