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.

Chu R, Brazauskas R, Kan F, Bashey A, Bredeson C, Camitta B, Chiang KY, Frangoul H, Gale RP, Gee A, George B, Goldman FD, Gross TG, Gupta V, Hale GA, Isola L, Ispizua AU, Lazarus H, Marsh J, Russell J, Sabloff M, Waller EK, Eapen M
Biol Blood Marrow Transplant. 2011 17 (7): 1018-24

PMID: 21034842 · PMCID: PMC3114180 · DOI:10.1016/j.bbmt.2010.10.029

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.

2011 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

MeSH Terms (29)

Adolescent Adult Anemia, Aplastic Bone Marrow Bone Marrow Transplantation Cause of Death Child Female Graft vs Host Disease Granulocyte Colony-Stimulating Factor Hematopoietic Stem Cell Mobilization Histocompatibility HLA Antigens Humans Leukocyte Count Living Donors Male Middle Aged Peripheral Blood Stem Cell Transplantation Platelet Count Postoperative Complications Registries Retrospective Studies Siblings Survival Rate Transplantation, Homologous Transplantation Conditioning Treatment Outcome Young Adult

Connections (1)

This publication is referenced by other Labnodes entities:

Links