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Peripheral Blood Stem Cells

Peripheral blood is safer than bone marrow as a source of hematopoietic progenitors in patients with myelodysplastic syndromes who receive an allogeneic transplantation. Results from the Spanish registry

Bone Marrow Transplantation volume 32, pages 987–992 (2003)Cite this article

Summary:

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative therapy for patients with myelodysplastic syndromes (MDSs). We have analyzed the outcome of 81 patients who underwent an allogeneic transplant from an HLA-identical sibling donor. The overall survival (OS) was 31% and disease-free survival was 30% at 5.8 years. Transplant-related complications were the cause of death in 44% and disease progression in 16% of patients. Acute graft-versus-host disease (aGVHD) grades II–IV occurred in 32 cases (39%). Extensive chronic GVHD (cGVHD) was observed in 27% of patients. When the log-rank test was performed, we observed that patients transplanted more than 6 months after diagnosis, and those transplanted with bone marrow (BM) displayed a shorter survival (P=0.009 and 0.005, respectively). Patients who developed cGVHD showed a trend towards better OS (P=0.07). Patients receiving BM had a higher incidence of aGVHD (65 vs 50%) and less cGVHD (52 vs 30%), although the differences did not reach statistical significance. Moreover, patients who received PB-HSC displayed a faster engraftment (P=0.000) and showed a significantly lower early transplant-related mortality (14 vs 42%; P=0.006) and longer OS (P=0.005). In summary, our results show that hematopoietic transplantation should be performed as soon as possible in MDS patients and that PB is preferable to BM as a source of HSC.

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Acknowledgements

We thank Professor JF San Miguel for his review of the manuscript.

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Authors and Affiliations

  1. Hospital Universitario de Salamanca, Spain

    M C del Cañizo & M V Mateos

  2. Hospital Clínico de Barcelona, Spain

    C Martínez

  3. Hospital Marqués de Valdecilla de Santander, Spain

    E Conde

  4. Hospital General de Murcia, Spain

    C Vallejo

  5. Hospital de Santa Creu y Sant Pau de Barcelona, Spain

    S Brunet

  6. Hospital La Fé de Valencia, Spain

    G Sanz

Authors
  1. M C del Cañizo
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  2. C Martínez
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  7. M V Mateos
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Correspondence to M C del Cañizo.

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On behalf of the Grupo Español de Trasplante Hematopoyético (GETH)

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del Cañizo, M., Martínez, C., Conde, E. et al. Peripheral blood is safer than bone marrow as a source of hematopoietic progenitors in patients with myelodysplastic syndromes who receive an allogeneic transplantation. Results from the Spanish registry. Bone Marrow Transplant 32, 987–992 (2003). https://doi.org/10.1038/sj.bmt.1704246

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