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Graft Outcome

Comparison of allogeneic T cell-depleted peripheral blood stem cell and bone marrow transplantation: effect of stem cell source on short- and long-term outcome

Bone Marrow Transplantation volume 27, pages 1053–1058 (2001)Cite this article

Abstract

We report the results of a retrospective single-center study comparing engraftment, acute and chronic GVHD, relapse and survival in patients with malignant hematological disorders transplanted with allogeneic peripheral blood stem cells (alloPBSCT, n = 40) or bone marrow cells (alloBMT, n = 42). All transplants were T cell depleted by in vitro incubation with the Campath-1 monoclonal antibody. Primary graft failure occurred in none of the patients receiving an alloPBSCT compared with 3/42 of the recipients of an alloBMT. In addition, two patients in the alloBMT group showed no platelet engraftment. Recipients of PBSC had a more rapid recovery of neutrophils (median 14 days) compared to BM transplant recipients (median 32 days). Platelet recovery was also accelerated in PBSC recipients compared to BM recipients (11 vs 38 days). There was an increase in the incidence of grade II acute GVHD and chronic GVHD in patients after alloPBSCT (18% and 23%, respectively) compared to patients receiving alloBMT (5% and 8%, respectively). The 2-year cumulative incidence of relapse was similar in both groups (47%). At 6 months after transplantation, transplant-related mortality (TRM) was lower in PBSCT recipients than in BMT recipients. However, at a follow-up of 3 years TRM was similar in both groups. The disease-free survival rate at 3 years after transplantation did not differ between the groups (42% for PBSCT and 41% for BMT recipients). Our results indicate that T cell-depleted alloPBSCT compared to alloBMT is associated with a more rapid hematopoietic reconstitution and a decreased TRM at 6 months follow-up after transplantation. However, at a follow-up of 3 years, no sustained survival benefits were observed. Bone Marrow Transplantation (2001) 27, 1053–1058.

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Acknowledgements

We gratefully acknowledge Monica Seltenheim for data management and Clary Wiarda and Noesja Nijssen for preparing the manuscript.

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Authors and Affiliations

  1. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    RMY Barge, RE Brouwer, CWJ Starrenburg, GJ den Ottolander, JHF Falkenburg, R Willemze & WE Fibbe

  2. Department of Virology, Leiden University Medical Center, Leiden, The Netherlands

    MFC Beersma

  3. Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands

    AH Zwinderman

  4. Sir William Dunn School of Pathology, University of Oxford, Oxford, UK

    G Hale & H Waldmann

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Barge, R., Brouwer, R., Beersma, M. et al. Comparison of allogeneic T cell-depleted peripheral blood stem cell and bone marrow transplantation: effect of stem cell source on short- and long-term outcome. Bone Marrow Transplant 27, 1053–1058 (2001). https://doi.org/10.1038/sj.bmt.1703024

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