Allogeneic transplantation of bone marrow versus peripheral blood stem cells from HLA-identical sibling donors for hematological malignancies in 6064 adults from 2003 to 2020: different impacts on survival according to time period.

Autor: Konuma T; Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp., Miyao K; Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan., Nakasone H; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Ouchi F; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan., Fukuda T; Hematopoietic Stem Cell Transplantation Division, National Cancer Hospital, Tokyo, Japan., Tanaka M; Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan., Ozawa Y; Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan., Ota S; Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan., Kawakita T; Department of Hematology, National Hospital Organisation Kumamoto Medical Center, Kumamoto, Japan., Uchida N; Department of Hematology, Toranomon Hospital, Tokyo, Japan., Sawa M; Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan., Katayama Y; Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan., Hiramoto N; Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan., Eto T; Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan., Ichinohe T; Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan., Atsuta Y; Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan., Kanda J; Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Jazyk: angličtina
Zdroj: Cytotherapy [Cytotherapy] 2024 Aug; Vol. 26 (8), pp. 910-920. Date of Electronic Publication: 2024 Mar 30.
DOI: 10.1016/j.jcyt.2024.03.489
Abstrakt: Background: Mobilized peripheral blood stem cells (PBSC) have been widely used instead of bone marrow (BM) as the graft source for allogeneic hematopoietic cell transplantation (HCT). Although early studies demonstrated no significant differences in survival between PBSC transplantation (PBSCT) and BM transplantation (BMT) from human leukocyte antigen (HLA)-identical sibling donors to adults with hematological malignancies, recent results have been unclear.
Objective: The objective of this retrospective study was to compare overall survival (OS), relapse, non-relapse mortality (NRM), hematopoietic recovery and graft-versus-host disease (GVHD) between PBSCT and BMT according to the time period of HCT (2003-2008, 2009-2014, or 2015-2020).
Study Design: We retrospectively compared the outcomes after PBSCT versus BMT in 6064 adults with hematological malignancies using a Japanese registry database between 2003 and 2020.
Results: The adjusted probability of OS was significantly higher in BMT recipients compared to PBSCT recipients during the early period of 2003-2008 (adjusted hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.70-0.91; P < 0.001) and the middle period of 2009-2014 (adjusted HR, 0.80; 95% CI, 0.70-0.91; P < 0.001). However, during the late period of 2015-2020, the adjusted probability of OS was comparable between BMT and PBSCT recipients (adjusted HR, 0.94; 95% CI, 0.79-1.13; P = 0.564), which were mainly due to the reduction of NRM. There was no significant difference in the relapse rate between the groups, irrespective of the time period. Compared to BMT, PBSCT led to faster neutrophil and platelet recovery and the cumulative incidences of grades II-IV and grades III-IV acute and overall and extensive chronic GVHD were significantly higher in PBSCT recipients, irrespective of the time period.
Conclusions: PBSCT and BMT had similar survival outcomes and relapse rates in adult patients with hematological malignancies during the late time period of 2015-2020 despite the hematopoietic recovery and acute and chronic GVHD being higher in PBSCT recipients in all time periods.
(Copyright © 2024 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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