Comparison of Outcomes after Transplantation of G-CSF-Stimulated Bone Marrow Grafts versus Bone Marrow or Peripheral Blood Grafts from HLA-Matched Sibling Donors for Patients with Severe Aplastic Anemia

被引：45

作者：

Chu, Roland ^{[2
]}

Brazauskas, Ruta

Kan, Fangyu ^{[3
]}

Bashey, Asad ^{[4
]}

Bredeson, Christopher

Camitta, Bruce

Chiang, Kuang-Yueh ^{[5
]}

Frangoul, Haydar ^{[6
]}

Gale, Robert Peter ^{[7
]}

Gee, Adrian ^{[8
]}

George, Biju ^{[9
]}

Goldman, Frederick D. ^{[10
]}

Gross, Thomas G. ^{[11
]}

Gupta, Vikas ^{[12
]}

Hale, Gregory A. ^{[13
]}

Isola, Luis ^{[14
]}

Urbana Ispizua, Alvaro ^{[15
]}

Lazarus, Hillard ^{[16
]}

Marsh, Judith ^{[17
]}

Russell, James ^{[18
]}

Sabloff, Mitchell ^{[19
]}

Waller, Edmund K. ^{[5
]}

Eapen, Mary ^{[1
]}

机构：

[1] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Ctr Stat, Milwaukee, WI 53226 USA

[2] Childrens Hosp Michigan, Detroit, MI 48201 USA

[3] Natl Marrow Donor Program, Minneapolis, MN USA

[4] Blood & Marrow Transplant Grp Georgia, Atlanta, GA USA

[5] Emory Univ, Atlanta, GA 30322 USA

[6] Vanderbilt Univ, Nashville, TN USA

[7] Celgene Corp, Summit, NJ USA

[8] Baylor Coll Med, Houston, TX 77030 USA

[9] Christian Med Coll & Hosp, Vellore, Tamil Nadu, India

[10] Childrens Hosp Alabama, Birmingham, AL USA

[11] Nationwide Childrens Hosp, Columbus, OH USA

[12] Princess Margaret Hosp, Toronto, ON M4X 1K9, Canada

[13] Univ S Florida, All Childrens Hosp, St Petersburg, FL 33701 USA

[14] Mt Sinai Med Ctr, New York, NY 10029 USA

[15] Hosp Univ Virgen del Rocio, Seville, Spain

[16] Case Western Reserve Univ, Cleveland, OH 44106 USA

[17] Kings Coll Hosp London, London, England

[18] Univ Calgary, Calgary, AB, Canada

[19] Univ Ottawa, Ottawa, ON, Canada

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2011年 / 17卷 / 07期

关键词：

G-mobilized BM; GVHD; Aplastic anemia; Survival; VERSUS-HOST-DISEASE; TERM-FOLLOW-UP; STEM-CELLS; PROGENITOR CELLS; HIGH-RISK; RECIPIENTS;

D O I：

10.1016/j.bbmt.2010.10.029

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We compared outcomes of patients with severe aplastic anemia (SAA) who received granulocyte-colony stimulating factor (G-CSF)-stimulated bone marrow (G-BM) (n=78), unstimulated bone marrow (BM) (n=547), or peripheral blood progenitor cells (PBPC) (n=134) from an HLA-matched sibling. Transplantations occurred in 1997 to 2003. Rates of neutrophil and platelet recovery were not different among the 3 treatment groups. Grade 2-4 acute graft-versus-host disease (aGVHD) (relative risk [RR]=0.82, P=.539), grade 3-4 aGVHD (RR=0.74, P=.535), and chronic GVHD (cGVHD) (RR=1.56, P=.229) were similar after G-BM and BM transplants. Grade 2-4 aGVHD (RR=2.37, P=.012) but not grade 3-4 aGVHD (RR=1.66, P=.323) and cGVHD (RR=5.09, P<.001) were higher after PBPC transplants compared to G-BM. Grade 2-4 (RR=2.90, P<.001), grade 3-4 (RR=2.24, P=.009) aGVHD and cGVHD (RR=3.26, P<.001) were higher after PBPC transplants compared to BM. Mortality risks were lower after transplantation of BM compared to G-BM (RR=0.63, P=.05). These data suggest no advantage to using G-BM and the observed higher rates of aGVHD and cGVHD in PBPC recipients warrants cautious use of this graft source for SAA. Taken together, BM is the preferred graft for HLA-matched sibling transplants for SAA. Biol Blood Marrow Transplant 17: 1018-1024 (2011) (C) 2011 American Society for Blood and Marrow Transplantation

引用

页码：1018 / 1024

页数：7

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