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Improved outcomes using G‐CSF ‐mobilized blood and bone marrow grafts as the source of stem cells compared with G‐PB after HLA ‐identical sibling transplantation in patients with acute leukemia
Author(s) -
Zhao Xiaosu,
Chen Yao,
Zhao Xiangyu,
Liu Daihong,
Xu Lanping,
Wang Yu,
Han Wei,
Chen Yuhong,
Chen Huan,
Zhang Xiaohui,
Liu Kaiyan,
Huang Xiaojun
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12225
Subject(s) - medicine , cumulative incidence , gastroenterology , transplantation , bone marrow , hematopoietic stem cell transplantation , granulocyte colony stimulating factor , immunology , acute leukemia , leukemia , surgery , chemotherapy
This retrospective study compared the transplantation outcomes of 98 consecutive patients with acute leukemia. Allogeneic hematopoietic stem cell transplantation was performed using G‐CSF‐mobilized bone marrow and blood (G‐BM&PB) or G‐CSF‐mobilized peripheral blood (G‐PB) from HLA‐identical sibling donors. The G‐BM&PB and G‐PB groups displayed significantly different neutrophil recovery rates (medians of 15 vs. 14 d, respectively; p = 0.009) but similar platelet recovery rates. The cumulative incidences of grades II–IV acute graft‐versus‐host disease ( aGVHD ) in the G‐BM&PB and G‐PB cohorts were similar (16.2 ± 4.7% vs. 21.8 ± 7.4%, respectively; p = 0.676), but the incidences of grades III‐IV aGVHD were significantly different (5.5 ± 3.1% vs. 18.9 ± 7.1%, respectively; p = 0.042). The G‐BM&PB and G‐PB cohorts displayed similar cumulative incidences of chronic GVHD ( cGVHD , 49.1 ± 5.7% vs. 42.7 ± 6.8%, respectively; p = 0.465), one‐yr cumulative incidences of treatment‐related mortality (16.5 ± 3.5% vs. 24.4 ± 4.1%, respectively; p = 0.220), and five‐yr cumulative incidences of relapse (13.9 ± 4.8% vs. 26.8 ± 7.2%, respectively; p = 0.113). The five‐yr probability of leukemia‐free survival (LFS) was significantly higher in the G‐BM&PB group than in the G‐PB group (77.8 ± 5.2% vs. 57.6 ± 8.6%, respectively; p = 0.023). Multivariate analysis identified G‐PB as an independent risk factor for grades III‐IV aGVHD and LFS. Our results suggest that HLA‐identical transplantation with G‐BM&PB results in superior clinical outcomes compared with G‐PB for patients with acute leukemia.