retrospective comparison of allogeneic peripheral blood stem cell versus bone marrow transplantation

ABSTRACT

Disease evolution depends in part on the source of transplanted cells. Therefore, we compared outcomes after allogeneic bone marrow [BM] and peripheral blood stem cell [PBSC] transplantation in patients who underwent transplant at Hospital das Clinicas of the Federal University of Minas Gerais, Brazil. We studied 364 patients who received allogeneic BM [n=142] or PBSC transplanttation [n=222] between July 1995 and May 2005. The median age of the patients was 31 years [range, 3.1-58 years]. Chronic myeloid leukemia was the predominant diagnosis [41.2%]. A conditioning regimen with cycclosphosphamide and busulfan was used in 79.4% [n=289] and graft-versus-host disease [GVHD] prophylaxis was cyclosporine/methotrexate in 95.9% [n=349] of cases. The patients in the PBSC group had faster neutrophil [P<.001] and platelet engraftment [P=.03] but increased rates of acute GVHD [P < .001] vs. those in the BM group. There was no significant difference between the groups in chronic GVHD, transplant-related mortality, relapse and survival rates. Although allogeneic PBSC transplant results in a faster hematopoietic engraftment, there was an increase in acute GVHD. There was no clear benefit in relapse rate and no evidence that transplantation with PBSC benefits patient survival in our institution