title: Comparison of Patient-Reported Outcomes in 5-Year Survivors Who Received Bone Marrow vs Peripheral Blood Unrelated Donor Transplantation: Long-term Follow-up of a Randomized Clinical Trial.
abstract: OBJECTIVE
  Bone marrow or peripheral blood from unrelated donors may be used for hematopoietic cell transplantation. Information about the relative success of transplantation with these 2 graft sources would help physicians and patients choose between them.
  
  
  OBJECTIVE
  To compare patient-reported outcomes between patients randomized to receive 1 of 2 graft types for unrelated donor transplantation.
  
  
  METHODS
  This follow-up of a randomized clinical trial included English- or Spanish-speaking patients 16 years or older participating in a multicenter randomized clinical trial of unrelated donor bone marrow (BM) vs peripheral blood (PB) (N = 551) in hematopoietic cell transplantation for hematologic neoplasms. Patient-reported outcomes were collected from patients at enrollment and 0.5, 1, 2, and 5 years after transplantation.
  
  
  METHODS
  Unrelated donor BM or PB hematopoietic cell transplantation.
  
  
  METHODS
  Functional Assessment of Cancer Therapy-Bone Marrow Transplant, Mental Health Inventory, occupational functioning, Lee Chronic Graft-vs-Host Disease Symptom Scale.
  
  
  RESULTS
  At 5 years after transplantation, 102 BM and 93 PB participants were alive and eligible for assessment (age ≥40 years or older: 104 [53.5%] male: 101 [51.8%]). The mean (SE) Mental Health Inventory Psychological Well-Being scores (78.9 [1.7] vs 72.2 [1.9]; P = .01; higher better) and Lee chronic graft-vs-host disease symptom scores (13.1 [1.5] vs 19.3 [1.6]; P = .004; lower better) were significantly better for BM recipients, adjusting for baseline scores and missing data. Recipients of BM were also more likely to be working full or part-time than recipients of PB (odds ratio, 1.5; 95% CI, 1.2-2.0; P = .002), adjusting for work status before transplantation. With a median follow-up of 73 months (range, 30-121 months) for survivors, no differences in survival (40% vs 39%; P = .84), relapse (32% vs 29%; P = .47), or treatment-related mortality (29% vs 32%; P = .44) between BM and PB were observed.
  
  
  CONCLUSIONS
  Recipients of unrelated donor BM had better psychological well-being, less burdensome chronic GVHD symptoms, and were more likely to return to work than recipients of PB at 5 years after transplantation. Bone marrow should be the standard of care for these types of transplant procedures.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00075816.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Milwaukee.
authors.forename: Brent
authors.initials: B
authors.lastname: Logan
authors.affiliation: Department of Medicine, Division of Oncology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Peter
authors.initials: P
authors.lastname: Westervelt
authors.affiliation: Division of Hematologic Malignancies and Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
authors.forename: Corey
authors.initials: C
authors.lastname: Cutler
authors.affiliation: Transplantation Biology Department, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Ann
authors.initials: A
authors.lastname: Woolfrey
authors.affiliation: Division of Pediatric Hematology-Oncology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Shakila P
authors.initials: SP
authors.lastname: Khan
authors.affiliation: Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.affiliation: Adult Blood and Marrow Stem Cell Transplant Program, Knight Cancer Institute, Oregon Health and Science University, Portland.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.affiliation: Emmes Corporation, Rockville, Maryland.
authors.forename: Juan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee.
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: Shaw
authors.affiliation: National Marrow Donor Program, Minneapolis, Minnesota.
authors.forename: Dennis
authors.initials: D
authors.lastname: Confer
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.affiliation: Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Claudio
authors.initials: C
authors.lastname: Anasetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D061349:Unrelated Donors