TY - JOUR
T1 - Effect of stem cell source on outcomes after unrelated donor transplantation in severe aplastic anemia
AU - Eapen, Mary
AU - Le Rademacher, Jennifer
AU - Antin, Joseph H.
AU - Champlin, Richard E.
AU - Carreras, Jeanette
AU - Fay, Joseph
AU - Passweg, Jakob R.
AU - Tolar, Jakub
AU - Horowitz, Mary M.
AU - Marsh, Judith C.W.
AU - Deeg, H. Joachim
PY - 2011/9/1
Y1 - 2011/9/1
N2 - 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-versushost 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.
AB - 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-versushost 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.
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U2 - 10.1182/blood-2011-05-354001
DO - 10.1182/blood-2011-05-354001
M3 - Article
C2 - 21677312
AN - SCOPUS:80052406910
SN - 0006-4971
VL - 118
SP - 2618
EP - 2621
JO - Blood
JF - Blood
IS - 9
ER -