Effect of stem cell source on outcomes after unrelated donor transplantation in severe aplastic anemia

  • Mary Eapen
  • , Jennifer Le Rademacher
  • , Joseph H. Antin
  • , Richard E. Champlin
  • , Jeanette Carreras
  • , Joseph Fay
  • , Jakob R. Passweg
  • , Jakub Tolar
  • , Mary M. Horowitz
  • , Judith C W Marsh
  • , H. Joachim Deeg

Research output: Contribution to journalArticlepeer-review

137 Scopus citations

Abstract

Outcome after unrelated donor bone marrow (BM) transplantation for severe aplastic anemia (SAA) has improved, with survival rates now approximately 75%. Increasing use of peripheral blood stem and progenitor cells (PBPCs) instead of BM as a graft source prompted us to compare outcomes of PBPC and BM transplantation for SAA. We studied 296 patients receiving either BM (n ∇ 225) or PBPC (n ∇ 71) from unrelated donors matched at human leukocyte antigen-A, -B, -C, -DRB1. Hematopoietic recovery was similar after PBPC and BM transplantation. Grade 2 to 4 acute graft-versushost disease risks were higher after transplantation of PBPC compared with BM (hazard ratio ∇ 1.68, P ∇ .02; 48% vs 31%). Chronic graft-versus-host disease risks were not significantly different after adjusting for age at transplantation (hazard ratio ∇ 1.39, P ∇ .14). Mortality risks, independent of age, were higher after PBPC compared with BM transplantation (hazard ratio ∇ 1.62,P ∇ .04; 76% vs 61%). These data indicate that BM is the preferred graft source for unrelated donor transplantation in SAA.

Original languageEnglish (US)
Pages (from-to)2618-2621
Number of pages4
JournalBlood
Volume118
Issue number9
DOIs
StatePublished - Sep 1 2011

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