Similar outcomes of peripheral blood stem cells vs. bone marrow for human leukocyte antigen‐matched unrelated donor transplantation in adult patients with acute myeloid leukemia using risk‐adapted graft‐versus‐host disease prophylaxis

Abstract

Our risk-adapted GVHD prophylaxis strategy resulted in similar transplant outcomes including comparable incidence of GVHD between the PBSC and BM groups in HLA-matched URD-SCT.

Is peripheral blood or bone marrow a better source of stem cells for transplantation in cases of HLA-matched unrelated donors? A meta-analysis

“…Which is not in accordance with the results of transplantations that were performed under a HLAidentical sibling setting [7,8,28]. And our conclusions were supported by other previous published studies [14,15,23]. On the contrary, other studies reported higher incidence of acute and chronic GVHD [14,16,29].…”

“…Several studies proved that the increased risk of GVHD could be controlled by transplantation protocols; an example is the use of risk-adapted GVHD prophylaxis [23], partial T-cell depletion or BM combined with PB as the source of stem cells [38,39]. The conclusion of our meta-analysis has some limitations because the included studies were not randomized and controlled.…”

“…After a median follow-up of 118 months, the DFS rate was significantly higher after PBSCT without increased GVHD, especially in late diseases; the OS rate was improved, and the incidence of TRM also decreased [10]. Conclusions are also controversial in HLA-matched or mismatched unrelated donor stem cell transplantations [11][12][13][14][15][16][17][18][19][20][21][22][23]. We conducted this meta-analysis in HLA-matched unrelated donors, and therefore our objective was to evaluate the prognostic effectiveness of peripheral-blood and bone marrow as sources of stem cells in hematopoietic stem cell transplantation that involves HLA-matched unrelated donors.…”

Peripheral Blood versus Bone Marrow from Unrelated Donors: Bone Marrow Allografts Have Improved Long-Term Overall and Graft-versus-Host Disease-Free, Relapse-Free Survival

“…In 2013, the primary results from BMT CTN0201 were published demonstrating comparable survival at 2 years for those randomized to PB and BM [2]. The failure to show a survival benefit in this trial as well as previous retrospective analyses [12][13][14][15][16][17][18][19] may have contributed to PB remaining the predominant graft source in roughly 80% of all URD recipients despite significantly higher rates of cGVHD and the need for prolonged immunosuppressants [1]. More recently published long-term patient-reported quality of life (QoL) data from the BMT CTN 0201 trial showed that at 5-years post-HCT, BM recipients reported significantly better QoL and were more likely to have returned to work compared with PB recipients; however, survival remained equivalent at 5 years [3].…”

Hematopoietic Stem Cell Source and Storage

“…The only significant difference was reported in chronic myeloid leukemia patients due to higher nonrelapse mortality rates in PB transplants [27]. In a Korean study, the difference in GVHD incidence could be overcomed by risk adapted GVHD prophylaxis in AML patients [28]. In aplastic anemia patients, the risk of death was higher with unrelated donors, but peripheral blood as a stem cell source was a negative predictor for outcomes [29].…”