Stephanie J Lee1, Brent Logan2, Peter Westervelt3, Corey Cutler4, Ann Woolfrey5, Shakila P Khan6, Edmund K Waller7, Richard T Maziarz8, Juan Wu9, Bronwen E Shaw10, Dennis Confer11, Mary M Horowitz10, Claudio Anasetti12. 1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. 2. Division of Biostatistics, Medical College of Wisconsin, Milwaukee. 3. Department of Medicine, Division of Oncology, Washington University School of Medicine, St Louis, Missouri. 4. Division of Hematologic Malignancies and Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts. 5. Transplantation Biology Department, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. 6. Division of Pediatric Hematology-Oncology, Mayo Clinic, Rochester, Minnesota. 7. Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia. 8. Adult Blood and Marrow Stem Cell Transplant Program, Knight Cancer Institute, Oregon Health and Science University, Portland. 9. Emmes Corporation, Rockville, Maryland. 10. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee. 11. National Marrow Donor Program, Minneapolis, Minnesota. 12. Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida.
Abstract
IMPORTANCE: Bone marrow or peripheral blood from unrelated donors may be used for hematopoietic cell transplantation. Information about the relative success of transplantation with these 2 graft sources would help physicians and patients choose between them. OBJECTIVE: To compare patient-reported outcomes between patients randomized to receive 1 of 2 graft types for unrelated donor transplantation. DESIGN, SETTING, AND PARTICIPANTS: This follow-up of a randomized clinical trial included English- or Spanish-speaking patients 16 years or older participating in a multicenter randomized clinical trial of unrelated donor bone marrow (BM) vs peripheral blood (PB) (N = 551) in hematopoietic cell transplantation for hematologic neoplasms. Patient-reported outcomes were collected from patients at enrollment and 0.5, 1, 2, and 5 years after transplantation. INTERVENTIONS: Unrelated donor BM or PB hematopoietic cell transplantation. MAIN OUTCOMES AND MEASURES: Functional Assessment of Cancer Therapy-Bone Marrow Transplant, Mental Health Inventory, occupational functioning, Lee Chronic Graft-vs-Host Disease Symptom Scale. RESULTS: At 5 years after transplantation, 102 BM and 93 PB participants were alive and eligible for assessment (age ≥40 years or older: 104 [53.5%] male: 101 [51.8%]). The mean (SE) Mental Health Inventory Psychological Well-Being scores (78.9 [1.7] vs 72.2 [1.9]; P = .01; higher better) and Lee chronic graft-vs-host disease symptom scores (13.1 [1.5] vs 19.3 [1.6]; P = .004; lower better) were significantly better for BM recipients, adjusting for baseline scores and missing data. Recipients of BM were also more likely to be working full or part-time than recipients of PB (odds ratio, 1.5; 95% CI, 1.2-2.0; P = .002), adjusting for work status before transplantation. With a median follow-up of 73 months (range, 30-121 months) for survivors, no differences in survival (40% vs 39%; P = .84), relapse (32% vs 29%; P = .47), or treatment-related mortality (29% vs 32%; P = .44) between BM and PB were observed. CONCLUSIONS AND RELEVANCE: Recipients of unrelated donor BM had better psychological well-being, less burdensome chronic GVHD symptoms, and were more likely to return to work than recipients of PB at 5 years after transplantation. Bone marrow should be the standard of care for these types of transplant procedures. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00075816.
IMPORTANCE: Bone marrow or peripheral blood from unrelated donors may be used for hematopoietic cell transplantation. Information about the relative success of transplantation with these 2 graft sources would help physicians and patients choose between them. OBJECTIVE: To compare patient-reported outcomes between patients randomized to receive 1 of 2 graft types for unrelated donor transplantation. DESIGN, SETTING, AND PARTICIPANTS: This follow-up of a randomized clinical trial included English- or Spanish-speaking patients 16 years or older participating in a multicenter randomized clinical trial of unrelated donor bone marrow (BM) vs peripheral blood (PB) (N = 551) in hematopoietic cell transplantation for hematologic neoplasms. Patient-reported outcomes were collected from patients at enrollment and 0.5, 1, 2, and 5 years after transplantation. INTERVENTIONS: Unrelated donor BM or PB hematopoietic cell transplantation. MAIN OUTCOMES AND MEASURES: Functional Assessment of Cancer Therapy-Bone Marrow Transplant, Mental Health Inventory, occupational functioning, Lee Chronic Graft-vs-Host Disease Symptom Scale. RESULTS: At 5 years after transplantation, 102 BM and 93 PB participants were alive and eligible for assessment (age ≥40 years or older: 104 [53.5%] male: 101 [51.8%]). The mean (SE) Mental Health Inventory Psychological Well-Being scores (78.9 [1.7] vs 72.2 [1.9]; P = .01; higher better) and Lee chronic graft-vs-host disease symptom scores (13.1 [1.5] vs 19.3 [1.6]; P = .004; lower better) were significantly better for BM recipients, adjusting for baseline scores and missing data. Recipients of BM were also more likely to be working full or part-time than recipients of PB (odds ratio, 1.5; 95% CI, 1.2-2.0; P = .002), adjusting for work status before transplantation. With a median follow-up of 73 months (range, 30-121 months) for survivors, no differences in survival (40% vs 39%; P = .84), relapse (32% vs 29%; P = .47), or treatment-related mortality (29% vs 32%; P = .44) between BM and PB were observed. CONCLUSIONS AND RELEVANCE: Recipients of unrelated donor BM had better psychological well-being, less burdensome chronic GVHD symptoms, and were more likely to return to work than recipients of PB at 5 years after transplantation. Bone marrow should be the standard of care for these types of transplant procedures. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00075816.
Authors: Nandita Khera; Barry Storer; Mary E D Flowers; Paul A Carpenter; Yoshihiro Inamoto; Brenda M Sandmaier; Paul J Martin; Stephanie J Lee Journal: J Clin Oncol Date: 2011-12-05 Impact factor: 44.544
Authors: R P McQuellon; G B Russell; D F Cella; B L Craven; M Brady; A Bonomi; D D Hurd Journal: Bone Marrow Transplant Date: 1997-02 Impact factor: 5.483
Authors: Jada G Hamilton; Lisa M Wu; Jane E Austin; Heiddis Valdimarsdottir; Katie Basmajian; Annamarie Vu; Scott D Rowley; Luis Isola; William H Redd; Christine Rini Journal: Psychooncology Date: 2012-05-18 Impact factor: 3.894
Authors: Stephanie J Lee; Daniel Wolff; Carrie Kitko; John Koreth; Yoshihiro Inamoto; Madan Jagasia; Joseph Pidala; Attilio Olivieri; Paul J Martin; Donna Przepiorka; Iskra Pusic; Fiona Dignan; Sandra A Mitchell; Anita Lawitschka; David Jacobsohn; Anne M Hall; Mary E D Flowers; Kirk R Schultz; Georgia Vogelsang; Steven Pavletic Journal: Biol Blood Marrow Transplant Date: 2015-03-19 Impact factor: 5.742
Authors: Nandita Khera; Eric J Chow; Wendy M Leisenring; Karen L Syrjala; K Scott Baker; Mary E D Flowers; Paul J Martin; Stephanie J Lee Journal: Biol Blood Marrow Transplant Date: 2010-12-08 Impact factor: 5.742
Authors: Abby R Rosenberg; Karen L Syrjala; Paul J Martin; Mary E Flowers; Paul A Carpenter; Rachel B Salit; K Scott Baker; Stephanie J Lee Journal: Cancer Date: 2015-08-19 Impact factor: 6.860
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
Authors: Pere Barba; Rodrigo Martino; Qin Zhou; Christina Cho; Hugo Castro-Malaspina; Sean Devlin; Albert Esquirol; Sergio Giralt; Ann A Jakubowski; Dolores Caballero; Molly Maloy; Esperanza B Papadopoulos; José Luís Piñana; María Laura Fox; Francisco J Márquez-Malaver; David Valcárcel; Carlos Solano; Lucía López-Corral; Jorge Sierra; Miguel-Angel Perales Journal: Biol Blood Marrow Transplant Date: 2018-01-02 Impact factor: 5.742
Authors: Armin Rashidi; Mehdi Hamadani; Mei-Jie Zhang; Hai-Lin Wang; Hisham Abdel-Azim; Mahmoud Aljurf; Amer Assal; Ashish Bajel; Asad Bashey; Minoo Battiwalla; Amer M Beitinjaneh; Nelli Bejanyan; Vijaya Raj Bhatt; Javier Bolaños-Meade; Michael Byrne; Jean-Yves Cahn; Mitchell Cairo; Stefan Ciurea; Edward Copelan; Corey Cutler; Andrew Daly; Miguel-Angel Diaz; Nosha Farhadfar; Robert P Gale; Siddhartha Ganguly; Michael R Grunwald; Theresa Hahn; Shahrukh Hashmi; Gerhard C Hildebrandt; H Kent Holland; Nasheed Hossain; Christopher G Kanakry; Mohamed A Kharfan-Dabaja; Nandita Khera; Yener Koc; Hillard M Lazarus; Jong-Wook Lee; Johan Maertens; Rodrigo Martino; Joseph McGuirk; Reinhold Munker; Hemant S Murthy; Ryotaro Nakamura; Sunita Nathan; Taiga Nishihori; Neil Palmisiano; Sagar Patel; Joseph Pidala; Rebecca Olin; Richard F Olsson; Betul Oran; Olov Ringden; David Rizzieri; Jacob Rowe; Mary Lynn Savoie; Kirk R Schultz; Sachiko Seo; Brian C Shaffer; Anurag Singh; Melhem Solh; Keith Stockerl-Goldstein; Leo F Verdonck; John Wagner; Edmund K Waller; Marcos De Lima; Brenda M Sandmaier; Mark Litzow; Dan Weisdorf; Rizwan Romee; Wael Saber Journal: Blood Adv Date: 2019-06-25
Authors: Laura F Newell; Kelsea M Shoop; Rebekah J Knight; Sara N Murray; Rogelyn P Kwock; Carol E Jacoby; Susan Slater; Bryon E Allen; Casondra Ottowa; Brad Cota; Peggy L Appel; Rachel J Cook; Richard T Maziarz; Gabrielle Meyers Journal: Cytotherapy Date: 2019-05-10 Impact factor: 5.414
Authors: Daniel A Keesler; Andrew St Martin; Carmem Bonfim; Adriana Seber; Mei-Jie Zhang; Mary Eapen Journal: Biol Blood Marrow Transplant Date: 2018-08-22 Impact factor: 5.742
Authors: Zachariah DeFilipp; Linda J Burns; Samantha M Jaglowski; Aaron L Leppin; Steven Pavletic; Bryce Waldman; Daniel J Weisdorf; William A Wood; Nandita Khera Journal: Biol Blood Marrow Transplant Date: 2020-09-10 Impact factor: 5.742