Peripheral blood stem cell transplantation from unrelated donors: a comparison with marrow transplantation

Blood. 1999 Jul 15;94(2):455-64.

Abstract

Peripheral blood stem cell (PBSC) transplants from HLA-A, -B, and -DR compatible unrelated donors (n = 45) were compared with bone marrow (BM; BM group, n = 45). Eighteen patients received CD34-selected PBSC (CD34 group). The PBSCs contained more mononuclear cells, CD34(+), CD3(+), and CD56(+) cells compared with marrow (P <.001). Engraftment was achieved in all 45 patients in the BM group, in 43 of 45 (95%) in the PBSC group, and in 14 of 18 (78%) in the CD34 group (P <.01). In multivariate analysis, a short time to absolute neutrophil count (ANC) equal to 0.5 x 10(9)/L was associated with the PBSC/CD34 groups (P <.001) and granulocyte colony-stimulating factor (G-CSF) treatment (P =.017). A short time to platelets equal to 50 x 10(9)/L was associated with PBSC (P =. 003) and no methotrexate (P =.015). Grades II-IV acute graft-versus-host disease (GVHD) was 20% in the BM controls, 30% in the PBSC group, and 18% in the CD34 group (not significant [NS]). The probability of chronic GVHD was 85% in the BM group, 59% in the PBSC group, and 0% in the CD34 group (P <.01). One-year transplant-related mortality was 21% and 27% and survival was 53% and 54% in the BM and PBSC groups, respectively (NS). The 2-year relapse-free survival was 41% and 46% in the two groups, respectively.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Marrow Transplantation* / adverse effects
  • Bone Marrow Transplantation* / mortality
  • Cause of Death
  • Disease-Free Survival
  • Female
  • Graft Survival
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / etiology
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Incidence
  • Leukocyte Count
  • Male
  • Methotrexate / pharmacology
  • Middle Aged
  • Neutrophils
  • Prospective Studies
  • Recurrence
  • Survival Analysis
  • Tissue Donors*
  • Transplantation Conditioning
  • Transplantation, Homologous* / adverse effects
  • Treatment Outcome

Substances

  • Granulocyte Colony-Stimulating Factor
  • Methotrexate