Paulo Vidal Campregher1, Nelson Hamerschlak2, Vergilio Antonio Renzi Colturato3, Marcos Augusto Mauad4, Mair Pedro de Souza5, Luis Fernando da Silva Bouzas6, Rita de Cássia B Tavares6, José Carlos Barros7, Ricardo Chiattone8, Alessandra Paz9, Lucia Silla9, Afonso Celso Vigorito10, Eliane Miranda11, Vaneuza Araújo Moreira Funke12, Mary Evelyn Flowers13. 1. Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil. 2. Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, São Paulo, Brazil. 3. Fundação Dr. Amaral Carvalho, Jaú, Brazil. 4. Clínica Segalla, Fundação Dr. Amaral Carvalho, Jaú, Brazil. 5. Hospital Amaral Carvalho, Jaú, Brazil. 6. Centro de Transplante de Medula Óssea (CEMO), Rio de Janeiro, Brazil. 7. Hematology and Oncology, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo, Brazil. 8. Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo, Brazil. 9. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 10. Hematology and Hemotherapy Center, Universidade Estadual de Campinas (UNICAMP), INCT do Sangue, Campinas, Brazil. 11. Hematology and Hemotherapy Center, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil. 12. Universidade Federal do Paraná (UFPR), Curitiba, Brazil. 13. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Abstract
OBJECTIVES: The objective of this study was to compare the major transplant outcomes between patients receiving hematopoietic stem cell transplantation (HSCT) from bone marrow (BM) or peripheral blood stem cells (PBSC). METHODS: All consecutive HSCT patients using BM or PBSC from an HLA-matched related donors for haematological malignancies after high intensity conditioning at seven Brazilian transplant centres between January 2008 and December 2009 were retrospectively evaluated. RESULTS: In the study period, 334 patients were treated in the centres and included in the evaluation. The cumulative incidence of grades II-IV and III-IV acute graft-versus-host disease (GVHD) at one year was 36.7% and 9.7% for BM recipients and 34.4% and 15.1% for PBSC recipients, respectively (not statistically different). The cumulative incidence of chronic GVHD at three years was 53.7% and 79.8% (HR 1.93; 95% CI 1.38-2.69, P < 0.001) for BM and PBSC, respectively. Median overall survival was 2.85 and 2.39 years for BM and PBSC recipients, respectively (HR 1.19; 95% CI, 0.84-1.68, P = 0.34). CONCLUSIONS: Our results confirm previous findings of increased chronic GVHD incidence in patients receiving PBSC when compared to patients receiving BM as the graft source in HSCT. Acute GVHD incidence, progression-free survival and overall survival were not different between the groups.
OBJECTIVES: The objective of this study was to compare the major transplant outcomes between patients receiving hematopoietic stem cell transplantation (HSCT) from bone marrow (BM) or peripheral blood stem cells (PBSC). METHODS: All consecutive HSCT patients using BM or PBSC from an HLA-matched related donors for haematological malignancies after high intensity conditioning at seven Brazilian transplant centres between January 2008 and December 2009 were retrospectively evaluated. RESULTS: In the study period, 334 patients were treated in the centres and included in the evaluation. The cumulative incidence of grades II-IV and III-IV acute graft-versus-host disease (GVHD) at one year was 36.7% and 9.7% for BM recipients and 34.4% and 15.1% for PBSC recipients, respectively (not statistically different). The cumulative incidence of chronic GVHD at three years was 53.7% and 79.8% (HR 1.93; 95% CI 1.38-2.69, P < 0.001) for BM and PBSC, respectively. Median overall survival was 2.85 and 2.39 years for BM and PBSC recipients, respectively (HR 1.19; 95% CI, 0.84-1.68, P = 0.34). CONCLUSIONS: Our results confirm previous findings of increased chronic GVHD incidence in patients receiving PBSC when compared to patients receiving BM as the graft source in HSCT. Acute GVHD incidence, progression-free survival and overall survival were not different between the groups.
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