PURPOSE: To compare hematologic recovery in patients receiving allogeneic blood cell transplantation (BCT) with those receiving allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS: One hundred eleven patients with leukemia in the early stages and with HLA-matched sibling donors were randomized in this study. One hundred one underwent transplantation. Standard procedures for collection and transplantation were used. Patients did not receive prophylactic granulocyte colony-stimulating factor after undergoing transplantation. In addition to clinical end points being established, a prospective and comparative economic evaluation of the first 6 months after transplantation was performed. RESULTS: Groups were balanced for patient, donor, and transplant characteristics. Blood cell collection led to the collection of a higher number of CD34(+) and CD3(+) cells than did bone marrow collection (P < 10(-6)) without reported side effects for the donor. Patients in the BCT group reached platelet counts of 25 and 50 x 10(9) platelets/L 8 and 11 days earlier than did the BMT group (P < 10(-4) and P < 10(-5)), respectively. This resulted in fewer platelet transfusions during the first 180 days after transplantation (P =.002) for the former group. The time to reach neutrophil counts of 0.5 and 1 x 10(9) neutrophils/L was 6 and 7 days shorter, respectively, in the BCT group than in the BMT group (P < 10(-5)). This quicker hematologic recovery was associated with a shorter length of hospitalization and a decrease in total cost of procedure during the first 6 months. CONCLUSION: This study establishes that allogeneic BCT results in quicker hematologic recovery but is associated with a higher occurrence of chronic graft-versus-host disease.
RCT Entities:
PURPOSE: To compare hematologic recovery in patients receiving allogeneic blood cell transplantation (BCT) with those receiving allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS: One hundred eleven patients with leukemia in the early stages and with HLA-matched sibling donors were randomized in this study. One hundred one underwent transplantation. Standard procedures for collection and transplantation were used. Patients did not receive prophylactic granulocyte colony-stimulating factor after undergoing transplantation. In addition to clinical end points being established, a prospective and comparative economic evaluation of the first 6 months after transplantation was performed. RESULTS: Groups were balanced for patient, donor, and transplant characteristics. Blood cell collection led to the collection of a higher number of CD34(+) and CD3(+) cells than did bone marrow collection (P < 10(-6)) without reported side effects for the donor. Patients in the BCT group reached platelet counts of 25 and 50 x 10(9) platelets/L 8 and 11 days earlier than did the BMT group (P < 10(-4) and P < 10(-5)), respectively. This resulted in fewer platelet transfusions during the first 180 days after transplantation (P =.002) for the former group. The time to reach neutrophil counts of 0.5 and 1 x 10(9) neutrophils/L was 6 and 7 days shorter, respectively, in the BCT group than in the BMT group (P < 10(-5)). This quicker hematologic recovery was associated with a shorter length of hospitalization and a decrease in total cost of procedure during the first 6 months. CONCLUSION: This study establishes that allogeneic BCT results in quicker hematologic recovery but is associated with a higher occurrence of chronic graft-versus-host disease.
Authors: Norbert Schmitz; Mary Eapen; Mary M Horowitz; Mei-Jie Zhang; John P Klein; J Douglas Rizzo; Fausto R Loberiza; Alois Gratwohl; Richard E Champlin Journal: Blood Date: 2006-08-31 Impact factor: 22.113
Authors: S Hahn; W Sireis; K Hourfar; D Karpova; K Dauber; V A J Kempf; E Seifried; M Schmidt; H Bönig Journal: Bone Marrow Transplant Date: 2013-11-04 Impact factor: 5.483
Authors: Madan Jagasia; Mukta Arora; Mary E D Flowers; Nelson J Chao; Philip L McCarthy; Corey S Cutler; Alvaro Urbano-Ispizua; Steven Z Pavletic; Michael D Haagenson; Mei-Jie Zhang; Joseph H Antin; Brian J Bolwell; Christopher Bredeson; Jean-Yves Cahn; Mitchell Cairo; Robert Peter Gale; Vikas Gupta; Stephanie J Lee; Mark Litzow; Daniel J Weisdorf; Mary M Horowitz; Theresa Hahn Journal: Blood Date: 2011-10-18 Impact factor: 22.113
Authors: Lauri Burroughs; Marco Mielcarek; Marie-Térèse Little; Gary Bridger; Ron Macfarland; Simon Fricker; Jean Labrecque; Brenda M Sandmaier; Rainer Storb Journal: Blood Date: 2005-08-16 Impact factor: 22.113
Authors: M S Thakar; P Kurre; R Storb; M Kletzel; H Frangoul; M A Pulsipher; W Leisenring; M E D Flowers; B M Sandmaier; A Woolfrey; H-P Kiem Journal: Bone Marrow Transplant Date: 2010-06-28 Impact factor: 5.483
Authors: Claudio Anasetti; Brent R Logan; Stephanie J Lee; Edmund K Waller; Daniel J Weisdorf; John R Wingard; Corey S Cutler; Peter Westervelt; Ann Woolfrey; Stephen Couban; Gerhard Ehninger; Laura Johnston; Richard T Maziarz; Michael A Pulsipher; David L Porter; Shin Mineishi; John M McCarty; Shakila P Khan; Paolo Anderlini; William I Bensinger; Susan F Leitman; Scott D Rowley; Christopher Bredeson; Shelly L Carter; Mary M Horowitz; Dennis L Confer Journal: N Engl J Med Date: 2012-10-18 Impact factor: 91.245