TY - JOUR
T1 - Hematopoietic recovery after allogeneic blood stem-cell transplantation compared with bone marrow transplantation in patients with hematologic malignancies
AU - Pavletic, Z. Steven
AU - Bishop, Michael R.
AU - Tarantolo, Stefano R.
AU - Martin-Algarra, Salvador
AU - Bierman, Philip J.
AU - Vose, Julie M.
AU - Reed, Elizabeth C.
AU - Gross, Thomas G.
AU - Kollath, Jeff
AU - Nasrati, Khalliq
AU - Jackson, John D.
AU - Armitage, James O.
AU - Kessinger, Anne
PY - 1997/4
Y1 - 1997/4
N2 - Purpose: To compare hematopoietic recovery, duration at hospitalization, and 100-day survival in patients who received allogeneic-blood stem cells (BSC) or conventional allogeneic bone marrow transplantation (BMT). Patients and Methods: From December 1994 to August 1995, 21 patients participated in a phase II study of allogeneic BSC transplantation. Cells mobilized with granulocyte colony-stimulating factor (G-CSF; 5 μg/kg/d) were collected from human leukocyte antigen (HLA)-matched related donors and cryopreserved. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate. G-CSF (10 μg/kg/d) was administered posttransplant. The outcomes were compared with 22 identically treated historical patients who received allogeneic BMT. Results: The median infused CD34+ cell and granulocyte-macrophage colony-forming unit (CFU-GM) content were 7.73 x 106/kg and 41.6 x 104/kg, respectively. The median time to a neutrophil count greater than 500/μL was 11 days after BSC and 16.5 days after BMT (P = .0003). A trend toward faster platelet and RBC recovery after BSC was observed. BSC patients received fewer platelet transfusions: 10 versus 19 (P = .015). The median length of hospitalization was shorter after BSC transplantation: 25 versus 31.5 days (P = .0243). The 100-day survival rates were similar: 83% after BSC and 75% after BMT (P = .3585). The incidence of acute GVHD grade II to IV was 57% and 45% for BSC and BMT, respectively (P = .4654). Conclusion: In comparison to BMT, allogeneic BSC transplantation may result in faster hematopoietic recovery, shorter hospital stay, and similar early survival. Whether allogeneic BSC are superior to bone marrow needs to be determined in randomized trials.
AB - Purpose: To compare hematopoietic recovery, duration at hospitalization, and 100-day survival in patients who received allogeneic-blood stem cells (BSC) or conventional allogeneic bone marrow transplantation (BMT). Patients and Methods: From December 1994 to August 1995, 21 patients participated in a phase II study of allogeneic BSC transplantation. Cells mobilized with granulocyte colony-stimulating factor (G-CSF; 5 μg/kg/d) were collected from human leukocyte antigen (HLA)-matched related donors and cryopreserved. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate. G-CSF (10 μg/kg/d) was administered posttransplant. The outcomes were compared with 22 identically treated historical patients who received allogeneic BMT. Results: The median infused CD34+ cell and granulocyte-macrophage colony-forming unit (CFU-GM) content were 7.73 x 106/kg and 41.6 x 104/kg, respectively. The median time to a neutrophil count greater than 500/μL was 11 days after BSC and 16.5 days after BMT (P = .0003). A trend toward faster platelet and RBC recovery after BSC was observed. BSC patients received fewer platelet transfusions: 10 versus 19 (P = .015). The median length of hospitalization was shorter after BSC transplantation: 25 versus 31.5 days (P = .0243). The 100-day survival rates were similar: 83% after BSC and 75% after BMT (P = .3585). The incidence of acute GVHD grade II to IV was 57% and 45% for BSC and BMT, respectively (P = .4654). Conclusion: In comparison to BMT, allogeneic BSC transplantation may result in faster hematopoietic recovery, shorter hospital stay, and similar early survival. Whether allogeneic BSC are superior to bone marrow needs to be determined in randomized trials.
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U2 - 10.1200/JCO.1997.15.4.1608
DO - 10.1200/JCO.1997.15.4.1608
M3 - Article
C2 - 9193360
AN - SCOPUS:0030897496
SN - 0732-183X
VL - 15
SP - 1608
EP - 1616
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 4
ER -