Long-Term Survival after Transplantation of Unrelated Donor Peripheral Blood or Bone Marrow Hematopoietic Cells for Hematologic Malignancy

Autor: Junfang Chen, Claudio Anasetti, Joseph H. Antin, Brent R. Logan, Ryotaro Nakamura, Philip L. McCarthy, Richard T. Maziarz, Mary Eapen, Ravi Vij, FR Appelbaum, Daniel R. Couriel, Voravit Ratanatharathorn, Richard E. Champlin
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
Transplantation Conditioning
Adolescent
Calcineurin Inhibitors
Graft vs Host Disease
Gastroenterology
Article
Leukemia
Myelogenous
Chronic
BCR-ABL Positive
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Transplantation
Homologous
Mortality
Survival analysis
Aged
Bone Marrow Transplantation
Peripheral Blood Stem Cell Transplantation
Transplantation
Acute leukemia
Leukemia
business.industry
Myelodysplastic syndromes
Myeloid leukemia
Hematology
Middle Aged
Myeloablative Agonists
Chronic graft-versus-host disease
medicine.disease
Survival Analysis
Leukemia
Biphenotypic
Acute
3. Good health
surgical procedures
operative
medicine.anatomical_structure
Myelodysplastic Syndromes
Chronic Disease
Immunology
Female
Bone marrow
Unrelated Donors
business
Zdroj: Biology of Blood and Marrow Transplantation. 21:55-59
ISSN: 1083-8791
DOI: 10.1016/j.bbmt.2014.09.006
Popis: We sought to determine whether differences in chronic graft-versus-host disease (GVHD) rates would lead to survival differences by comparing 2463 peripheral blood (PB) and 1713 bone marrow (BM) hematopoietic cell transplant recipients. Patients had acute leukemia, chronic myeloid leukemia (CML), or myelodysplastic syndrome, and they received myeloablative conditioning regimens and calcineurin-inhibitor GVHD prophylaxis. There were no significant differences in long-term survival after transplantation of PB and BM, except for patients in first chronic phase CML. For these patients, the 5-year rate of survival was lower after transplantation of PB compared with transplantation of BM (35% versus 56%, P = .001). Although mortality risks were higher in patients with chronic GVHD after both PB (hazard ratio [HR], 1.58; P < .001) and BM (HR 1.73; P < .001) transplantations, its effect on mortality did not differ by graft type (P = .42). BM is the preferred graft for first chronic phase CML, whereas as either graft is suitable for other leukemias.
Databáze: OpenAIRE
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