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Mobilized peripheral blood stem cells compared with bone marrow from HLA ‐identical siblings for reduced‐intensity conditioning transplantation in acute myeloid leukemia in complete remission: a retrospective analysis from the A cute Leukemia W orking P arty of EBMT
Author(s) -
Nagler Ar,
Labopin Myriam,
Shimoni Avichai,
Mufti Ghulam J.,
Cornelissen Jan J.,
Blaise Didier,
Janssen Jeroen J. W. M.,
Milpied Noel,
Vindelov Lars,
Petersen Eefke,
Gribben John,
Bacigalupo Andrea,
Malm Claes,
Niederwieser Dietger,
Socié Gerard J.,
Arnold Renate,
Brown Paul,
Goker Hakan,
Rocha Vanderson,
Mohty Mohamad
Publication year - 2012
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2012.01811.x
Subject(s) - medicine , bone marrow , leukemia , myeloid leukemia , acute leukemia , transplantation , gastroenterology , stem cell , immunology , oncology , biology , genetics
Reduced‐intensity conditioning ( RIC )‐allo SCT is increasingly used for acute myelogenous leukemia. Limited data are available for the comparison of peripheral blood stem cells with bone marrow for RIC ‐allo SCT . We used the E uropean G roup for B lood and M arrow T ransplantation ( EBMT ) ALWP data to compare the outcome of mobilized peripheral blood stem cells ( PBSC ) ( n  = 1430) vs. bone marrow ( BM ) ( n  = 107) for acute myelogenous leukemia ( AML ) patients with complete remission that underwent RIC ‐allo SCT from compatible sibling donors. The leukemia features, the disease status, and the time from diagnosis were similar between the two groups. Engraftment was achieved in 99% and 93% in the PBSC and BM groups, respectively ( P  <   0.0001). The day of engraftment was significantly earlier for the PBSC vs. the BM group, 15 (1–59) and 19 (5–69), respectively ( P  < 0.001). Acute GVHD , severe GVHD (grade III–IV) and chronic GVHD did not differ between the groups. leukemia‐free survival ( LFS ), relapse, and non‐relapsed mortality ( NRM ) were 51 ± 2%, 32 ± 1%, and 17 ± 1% vs. 50 ± 6%, 38 ± 6%, and 12 ± 3% for the PBSC and BM groups, respectively. Our results indicate faster engraftment, but no difference in GVHD , LFS , relapse, and NRM when comparing PBSC to BM grafts from sibling donors following RIC conditioning. This is the first study comparing PBSC to BM grafts in the RIC setting, analyzing a homogeneous population of patients with AML in remission. Whether PBSC should be preferred for advanced phases of the disease, where the outcome is dominated by relapse incidences, needs further investigation.

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