Matched-pair analysis of peripheral blood stem cells compared to marrow for allogeneic transplantation

J. D. Lickliter, P. B. McGlave, T. E. DeFor, J. S. Miller, N. K. Ramsay, C. M. Verfaillie, L. J. Burns, J. E. Wagner, T. Eastlund, K. Dusenbery, D. J. Weisdorf

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17 Scopus citations

Abstract

We performed a case-control analysis of 42 patients with advanced leukemia or MDS comparing peripheral blood stem cell (PBSC) with marrow grafts (BMT) from HLA-matched sibling donors. PBSC were mobilized with G-CSF (7.5 μg/kg/day) and yielded a median of 6.7 x 106 CD34+ cells/kg (range, 1.6-15.0) and 2.7 x 108 CD3+ cells/kg (range, 1.1-7.1) vs marrow grafts with a median of 2.0 x 108 nucleated cells/kg (range, 1.8-2.2). Recovery was significantly faster after PBSCT compared to BMT, with a median of 17 (range, 12-26) vs 26 (range, 16-36) days, respectively, to neutrophils >0.5 x 109/l (P < 0.01), and 22 (range, 12->60) vs 42 (range, 18->60) days, for platelet recovery (P < 0.01). Transplantation of ≥7 x 106 CD34+ cells/kg accelerated recovery to >20 x 109 l platelets; median 17 days (range, 12-19) vs 23 days (range, 17-36) for those receiving <7 x 106/kg (P = 0.01). PBSC and marrow recipients had similar risks of grades II-IV or III-IV acute GVHD or extensive chronic GVHD (all P > 0.3). At 1 year after PBSCT and BMT, the risk of relapse was 41% and 32%, respectively (P = 0.47), and the probability of survival was 46% and 48%, respectively (P = 0.70). HLA-matched sibling PBSCT resulted in faster neutrophil and platelet engraftment compared to BMT, with no subsequent differences in acute or chronic GVHD, relapse or survival. A minimum of 7 x 106 CD34+ cells/kg in PBSC grafts may be required for very rapid platelet engraftment.

Original languageEnglish (US)
Pages (from-to)723-728
Number of pages6
JournalBone marrow transplantation
Volume26
Issue number7
DOIs
StatePublished - 2000

Keywords

  • Allogeneic
  • BMT
  • Blood stem cells
  • Engraftment

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