Abstract
There is limited experience in the use of peripheral blood progenitor cells (PBPC) for allogeneic transplantation in children. In the present study we compared engraftment kinetics, incidence of acute and chronic graft-versus-host disease (GVHD) and the outcome and economic costs of allogeneic PBPCT vs BMT in children with ALL in a single institution. All children were transplanted in complete remission (CR) with a similar conditioning regimen and the same GVHD prophylaxis. Patients undergoing PBPCT achieved myeloid and platelet engraftment before patients undergoing BMT (P < 0.001). platelet recovery was faster for the pbpct group (P < 0.014 for 50 × 109/l and P < 0.039 for 100 × 109/l). Incidence and severity of acute and chronic GVHD were similar in both groups (acute grade 1–2: 9/13 for PBPCT vs 9/11 for BMT; chronic GVHD: 5/12 for PBPCT vs 3/8 for BMT). Hospital stay was shorter for the PBPCT than for the BMT group (28.8 days vs42.9 days, respectively) and the PBPCT group used less clinical resources, resulting in overall lower cost for PBPCT (US $14046) compared to BMT (US $19840). There was no statistically significant difference in DFS between PBPCT and BMT (68.4% vs 50%, respectively). Bone Marrow Transplantation (2000) 26, 269–273.
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References
Sanders JE, Thomas ED, Buckner CD et al. Marrow transplantation in children with acute lymphoblastic leukemia in second remission Blood 1987 70: 324–326
McCarthy DM, Barret AJ, McDonald D et al. Bone marrow transplantation for adults and children with poor risk acute lymphoblastic leukemia in first complete remission Bone Marrow Transplant 1998 3: 315–322
Bordigoni P, Vernant J, Sonillet G et al. Allogeneic bone marrow transplantation after hyperfractioned total body irradiation and cyclophosphamide in children with acute lymphoblastic leukemia in first remission: a co-operative study of the Groupe d'Etude de la Greffe de Moelle Osseuse J Clin Oncol 1989 7: 747–753
Lasky LC, Bostrone B, Smith J et al. Clinical collection and use of peripheral blood stem cell in pediatric patients Transplantation 1989 47: 613–616
Watanabe T, Takaue Y, Kawano Y et al. Peripheral blood stem cell autotransplantation in treatment of childhood with cancer Bone Marrow Transplant 1989 4: 261–265
Takaue Y, Watanabe T, Kawano Y et al. Isolation and storage of peripheral blood hematopoietic stem cells for autotransplantation into children with cancer Blood 1989 74: 1245–1251
Bensinger WI, Waver C, Appelbaum F et al. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony stimulating factor Blood 1995 85: 1655–1658
Korbling M, Pzierporka D, Huh Y et al. Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantages of blood over marrow allograft Blood 1995 85: 1659–1666
Schmitz N, Dreger P, Sutturgh M et al. Primary transplantation of allogeneic peripheral blood progenitor cells mobilized by filgastrim Blood 1995 85: 1666–1672
Díaz MA, Alegre A, Villa M et al. Allogeneic peripheral blood progenitor cell (PBPC) in children with hematological malignancies Br J Haematol 1997 96: 161–164
Li CK, Yuen PMP, Chik KW et al. Allogeneic peripheral blood stem cell transplant in children Med Ped Oncol 1998 30: 147–151
Villa M, Madero L, Díaz MA et al. Allogeneic peripheral blood progenitor cell (PBPC) transplantation in children Bone Marrow Transplant 1996 18: 231–233
Miflin G, Russell NH, Hutchinson RM et al. Allogeneic peripheral blood stem cell transplantation: analysis of engraftment and GVHD risk Bone Marrow Transplant 1997 19: 9–13
Bensinger WI, Clift R, Martín P et al. Allogeneic peripheral blood stem cell transplantation in patients with advanced hematological malignancies. A retrospective comparison with marrow transplantation Blood 1996 88: 2794–2800
Majolino I, Saglio G, Scime R et al. High incidence of chronic GVHD after primary allogeneic peripheral blood stem cell transplantation in patients with hematologic malignancies Bone Marrow Transplant 1996 17: 555–560
Solano C, Martínez C, Brunet S et al. Chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell or bone marrow transplantation from matched related donors. A case-control study Bone Marrow Transplant 1998 22: 1129–1135
Bennett Cl, Waters TM, Stinson TJ et al. Valuing clinical strategies early in development: a cost analysis of allogeneic peripheral blood stem cell transplantation Bone Marrow Transplant 1999 24: 555–560
González M, Benito A, Díaz MA . Peripheral blood progenitor cell (PBPC) collection by LVL from pediatric donors Bone Marrow Transplant 1999 23: 631–633
Alegre A, Díaz MA, Madero L et al. Large volume leukapheresis for peripheral blood stem cell collection in children: a simplified single-apheresis approach Bone Marrow Transplant 1996 17: 923–927
Clift RA, Buckner CD, Thomas ED et al. Allogeneic bone marrow transplantation using fractionated total body irradiation in patients with acute lymphoblastic leukemia in relapse Leukemia Res 1982 6: 401–407
Tutshka PJ, Copeland EA, Klein JP . Bone marrow transplantation for leukemia following a new busulphan and cyclophosphamide regimen Blood 1987 70: 1382–1388
Martino R, Badell I, Brunet S et al. High-dose busulphan and melphalan before bone marrow for acute non-lymphoblastic leukemia Bone Marrow Transplant 1989 4: 559–565
Thomas ED, Storb R, Clift RA . Bone marrow transplantation New Engl J Med 1995 292: 891–895
Russell NH, Hunter A, Rogers S et al. Peripheral blood stem cells as an alternative to marrow for allogeneic transplantation (letter) Lancet 1993 341: 1487
Van Hoef MEHM . The IBMTR and European Group for Blood and Marrow Transplantation initiate two timely joint projects The IBMTR Newsletter of the IBMTR/ABMTR Statistical Center, Milwaukee, Wisconsin, July 1997
Verdeguer A, Bermudez M, De la Rubia J et al. Allogeneic PBPC transplantation in children Cytotherapy 1999 1: 195–201.
Russell JA, Brown C, Bowen T et al. Allogeneic blood cell transplants for haematological malignancy: preliminary comparison of outcomes with bone marrow transplantation Bone Marrow Transplant 1996 17: 703–708
Schmitz N, Champlin R, Horowitz M et al. Peripheral blood progenitor cell (PBPC) vs bone marrow (BM) transplants from HLA-identical donors. A joint analysis of the International Bone Marrow Transplant Registry (IBMR) an the European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1998 21: (Suppl. 1) A155
Couban S, Dranitsaris G, Andreon P et al. Clinical and economic analysis of allogeneic peripheral blood progenitor cells transplants: a Canadian perspective Bone Marrow Transplant 1998 22: 1199–1205
Welch HG, Larson EB . Cost effectiveness of bone marrow transplantation in acute non-lymphocytic leukemia New Engl J Med 1989 321: 807–812
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Madero, L., Vicent, M., Ramirez, M. et al. Clinical and economic comparison of allogeneic peripheral blood progenitor cell and bone marrow transplantation for acute lymphoblastic leukemia in children. Bone Marrow Transplant 26, 269–273 (2000). https://doi.org/10.1038/sj.bmt.1702516
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DOI: https://doi.org/10.1038/sj.bmt.1702516
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