BACKGROUND AND OBJECTIVES: Peripheral blood stem cells (PBSC) following reduced intensity conditioning (RIC) are being increasingly used for allogeneic transplantation in multiple myeloma. The purpose of this study was to compare outcome of patients transplanted with either PBSC or bone marrow (BM) following RIC or myeloablative conditioning (MAC). DESIGN AND METHODS: Data from 1,667 patients who had received an allogeneic identical sibling donor transplant for multiple myeloma from 1994 to 2003 were analyzed. Comparisons were made between results of PBSC and BM transplants after conditioning with RIC or MAC. RESULTS: The engraftment rate was faster with PBSC than with BM (median: 14 and 18 days for neutrophils and 15 and 25 days for platelets respectively) irrespectively of whether RIC or MAC was used. The incidence of acute graft-versus-host disease (GVHD) did not differ significantly between the groups while chronic GVHD was more prevalent in PBSC recipients irrespectively of whether they had RIC or MAC. Non-relapse mortality did not differ between PBSC and BM recipients, but was significantly higher in those treated with MAC than in those given RIC irrespectively of the cell source. The relapse/progression rate did not differ between PBSC and BM recipients, but was significantly higher in those given RIC, irrespectively of the cell source. There was no significant difference in overall or progression-free survival between patients given PBSC or BM transplants. INTERPRETATION AND CONCLUSIONS: Although transplantation of PBSC is associated with faster engraftment and more frequent chronic GVHD, overall survival, non-relapse mortality, relapse/progression and progression-free survival are similar to those following BM transplants. However both PBSC and BM transplants are associated with lower non-relapse mortality, lower response rate and higher relapse/progression if RIC is used instead of MAC.
BACKGROUND AND OBJECTIVES: Peripheral blood stem cells (PBSC) following reduced intensity conditioning (RIC) are being increasingly used for allogeneic transplantation in multiple myeloma. The purpose of this study was to compare outcome of patients transplanted with either PBSC or bone marrow (BM) following RIC or myeloablative conditioning (MAC). DESIGN AND METHODS: Data from 1,667 patients who had received an allogeneic identical sibling donor transplant for multiple myeloma from 1994 to 2003 were analyzed. Comparisons were made between results of PBSC and BM transplants after conditioning with RIC or MAC. RESULTS: The engraftment rate was faster with PBSC than with BM (median: 14 and 18 days for neutrophils and 15 and 25 days for platelets respectively) irrespectively of whether RIC or MAC was used. The incidence of acute graft-versus-host disease (GVHD) did not differ significantly between the groups while chronic GVHD was more prevalent in PBSC recipients irrespectively of whether they had RIC or MAC. Non-relapse mortality did not differ between PBSC and BM recipients, but was significantly higher in those treated with MAC than in those given RIC irrespectively of the cell source. The relapse/progression rate did not differ between PBSC and BM recipients, but was significantly higher in those given RIC, irrespectively of the cell source. There was no significant difference in overall or progression-free survival between patients given PBSC or BM transplants. INTERPRETATION AND CONCLUSIONS: Although transplantation of PBSC is associated with faster engraftment and more frequent chronic GVHD, overall survival, non-relapse mortality, relapse/progression and progression-free survival are similar to those following BM transplants. However both PBSC and BM transplants are associated with lower non-relapse mortality, lower response rate and higher relapse/progression if RIC is used instead of MAC.
Authors: Shaji Kumar; Mei-Jie Zhang; Peigang Li; Angela Dispenzieri; Gustavo A Milone; Sagar Lonial; Amrita Krishnan; Angelo Maiolino; Baldeep Wirk; Brendan Weiss; César O Freytes; Dan T Vogl; David H Vesole; Hillard M Lazarus; Kenneth R Meehan; Mehdi Hamadani; Michael Lill; Natalie S Callander; Navneet S Majhail; Peter H Wiernik; Rajneesh Nath; Rammurti T Kamble; Ravi Vij; Robert A Kyle; Robert Peter Gale; Parameswaran N Hari Journal: Blood Date: 2011-06-20 Impact factor: 22.113
Authors: L Rosiñol; R Jiménez; M Rovira; C Martínez; F Fernández-Avilés; P Marín; M Suárez-Lledó; G Gutiérrez-García; C Fernández de Larrea; E Carreras; A Urbano-Ispizua; J Bladé Journal: Bone Marrow Transplant Date: 2015-01-26 Impact factor: 5.483
Authors: Qaiser Bashir; Hassan Khan; Peter F Thall; Ping Liu; Nina Shah; Partow Kebriaei; Simrit Parmar; Betul Oran; Stefan Ciurea; Yago Nieto; Roy Jones; Chitra M Hosing; Uday R Popat; Yvonne T Dinh; Gabriela Rondon; Robert Z Orlowski; Jatin J Shah; Marcos De Lima; Elizabeth Shpall; Richard Champlin; Sergio Giralt; Muzaffar H Qazilbash Journal: Biol Blood Marrow Transplant Date: 2013-07-17 Impact factor: 5.742
Authors: E Gomez; R Duléry; C Langlois; V Coiteux; L Terriou; L Magro; J Gauthier; E de Berranger; A Duhamel; I Yakoub-Agha Journal: Bone Marrow Transplant Date: 2014-09-15 Impact factor: 5.483
Authors: W Bensinger; M Rotta; B Storer; T Chauncey; L Holmberg; P Becker; B M Sandmaier; R Storb; D Maloney Journal: Bone Marrow Transplant Date: 2012-02-13 Impact factor: 5.483