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Effect of stem cell source on outcomes after unrelated donor transplantation in severe aplastic anemia. Blood 2011 Sep 01;118(9):2618-21 PMID: 21677312 PMCID: PMC3167362

Pubmed ID

21677312

DOI

10.1182/blood-2011-05-354001

Abstract

Outcome after unrelated donor bone marrow (BM) transplantation for severe aplastic anemia (SAA) has improved, with survival rates now approximately 75%. Increasing use of peripheral blood stem and progenitor cells (PBPCs) instead of BM as a graft source prompted us to compare outcomes of PBPC and BM transplantation for SAA. We studied 296 patients receiving either BM (n = 225) or PBPC (n = 71) from unrelated donors matched at human leukocyte antigen-A, -B, -C, -DRB1. Hematopoietic recovery was similar after PBPC and BM transplantation. Grade 2 to 4 acute graft-versus-host disease risks were higher after transplantation of PBPC compared with BM (hazard ratio = 1.68, P = .02; 48% vs 31%). Chronic graft-versus-host disease risks were not significantly different after adjusting for age at transplantation (hazard ratio = 1.39, P = .14). Mortality risks, independent of age, were higher after PBPC compared with BM transplantation (hazard ratio = 1.62, P = .04; 76% vs 61%). These data indicate that BM is the preferred graft source for unrelated donor transplantation in SAA.

Author List

Eapen M, Le Rademacher J, Antin JH, Champlin RE, Carreras J, Fay J, Passweg JR, Tolar J, Horowitz MM, Marsh JC, Deeg HJ

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-80052406910   83 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Anemia, Aplastic
Bone Marrow Transplantation
Child
Child, Preschool
Female
Graft Survival
Graft vs Host Disease
Histocompatibility
Humans
Infant
Kaplan-Meier Estimate
Karnofsky Performance Status
Male
Middle Aged
Organ Specificity
Peripheral Blood Stem Cell Transplantation
Proportional Hazards Models
Registries
Retrospective Studies
Tissue Donors
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Young Adult
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70