Patients with acute lymphoblastic leukaemia allografted with a matched unrelated donor may have a lower survival with a peripheral blood stem cell graft compared to bone marrow

被引:33
作者
Garderet, L
Labopin, M
Gorin, NC
Polge, E
Fouillard, L
Ehninger, GE
Ringden, O
Finke, J
Tura, S
Frassoni, F
机构
[1] Hop St Antoine AP HP, Serv Hematol, F-75571 Paris 12, France
[2] Ctr Int Greffes AP HP, Inst Cordeliers, Paris, France
[3] Univ Paris 06, Assoc Claude Bernard, Ctr Rech Therapie Cellulaire, Paris, France
[4] Univ Paris 06, Equipe Accueil EA 1638, Paris, France
[5] Univ Klinikum Dresden, Med Klin 1, Dresden, Germany
[6] Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden
[7] Univ Freiburg, Dept Med Hematol, Freiburg, Germany
[8] San Orsola Hosp, Inst Hematol & Med Oncol Seragnoli, Bologna, Italy
[9] San Martino Hosp, Dept Hematol, Genoa, Italy
关键词
acute leukaemia; allogeneic transplantation; peripheral blood stem cells; unrelated donor;
D O I
10.1038/sj.bmt.1703778
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
We analysed data for 213 patients with ALL and AML who received either peripheral blood stem cells (PBSC) (n = 74) or bone marrow (BM) (n = 139) from an HLA-matched unrelated donor (EBMT acute leukaemia registry; January 1994 to January 1999). The two groups of patients (by cell source) were comparable with respect to age, sex, disease status, year at transplant and graft T cell depletion. Engraftment was achieved in about 90% regardless of stem cell source or leukaemia type. Kinetics of neutrophil and platelet recovery, similar for both sources in ALL patients, were faster for PBSC in AML patients. The incidence of acute graft-versus-host disease was similar for both sources in AML patients, but higher for PBSC in ALL patients (74 vs 54%, P = 0.05). The 1-year probability of chronic graft-versus-host disease was 40 and 45% (P = 0.66) in ALL patients compared to 49 and 35% (P = 0.13) in AML patients (PBSC vs BM). In AML patients, none of the following differed significantly with cell source: transplant-related mortality, relapse incidence, leukaemia-free survival and overall survival. In ALL patients, the transplant-related mortality for PBSC vs BM was 61 vs 47% (P=0.13), the relapse incidence was 47 vs 39% (P=0.17), the leukaemia-free survival was 21 vs 32% (P = 0.04) and the overall survival was 24 vs 34% (P=0.04). These data suggest that the short-term outcome of allogeneic PBSC is not significantly different from that of BM in AML patients who underwent a transplant from a matched unrelated donor but, conversely, that survival with PBSC may be decreased in ALL patients. In conclusion, the source of transplant cells needs to be evaluated by disease, especially when dealing with unrelated donors.
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收藏
页码:23 / 29
页数:7
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