Abstract
We performed a case-control analysis of 42 patients with advanced leukemia or MDS comparing peripheral blood stem cell (PBSC) with marrow grafts (BMT) from HLA-matched sibling donors. PBSC were mobilized with G-CSF (7.5 μg/kg/day) and yielded a median of 6.7 × 106 CD34+ cells/kg (range, 1.6–15.0) and 2.7 × 108 CD3+ cells/kg (range, 1.1–7.1) vs marrow grafts with a median of 2.0 × 108 nucleated cells/kg (range, 1.8–2.2). Recovery was significantly faster after PBSCT compared to BMT, with a median of 17 (range, 12–26) vs 26 (range, 16–36) days, respectively, to neutrophils >0.5 × 109/l (P < 0.01), and 22 (range, 12–>60) vs 42 (range, 18–>60) days, for platelet recovery (P < 0.01). transplantation of ⩾7 × 106 CD34+ cells/kg accelerated recovery to >20 × 109 l platelets; median 17 days (range, 12–19) vs 23 days (range, 17–36) for those receiving <7 × 106/kg (P = 0.01). PBSC and marrow recipients had similar risks of grades II–IV or III–IV acute GVHD or extensive chronic GVHD (all P > 0.3). At 1 year after PBSCT and BMT, the risk of relapse was 41% and 32%, respectively (P = 0.47), and the probability of survival was 46% and 48%, respectively (P = 0.70). HLA-matched sibling PBSCT resulted in faster neutrophil and platelet engraftment compared to BMT, with no subsequent differences in acute or chronic GVHD, relapse or survival. A minimum of 7 × 106CD34+ cells/kg in PBSC grafts may be required for very rapid platelet engraftment. Bone Marrow Transplantation (2000) 26, 723–728.
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Lickliter, J., McGlave, P., DeFor, T. et al. Matched-pair analysis of peripheral blood stem cells compared to marrow for allogeneic transplantation. Bone Marrow Transplant 26, 723–728 (2000). https://doi.org/10.1038/sj.bmt.1702606
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DOI: https://doi.org/10.1038/sj.bmt.1702606
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