Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Daniel A KeeslerMary Eapen

Abstract

Graft-versus-host disease (GVHD) rates are higher after unrelated donor transplantation; thus, we examined whether there would be differences in transplant outcomes by graft type in children and adolescents with acute leukemia. The primary endpoint was overall survival. We studied 872 patients <18 years old who were transplanted with bone marrow (n = 650) or peripheral blood (n = 222) from unrelated donors. The characteristics of the 2 groups were comparable, except recipients of bone marrow were younger than recipients of peripheral blood (median age, 10 versus 12 years). Grades 2 to 4 (hazard ratio [HR], 1.48; P < .001) and grades 3 and 4 acute (HR, 1.69; P < .001) and chronic GVHD (HR, 1.92; P < .001) were higher with transplantation of peripheral blood than with bone marrow. Although relapse risks were lower after peripheral blood transplants (HR, 0.76; P = .05), transplant-related mortality (HR, 1.91; P = .003) and overall mortality (HR, 1.34; P = .032) were higher than with bone marrow transplants. The 8-year probability of overall survival after transplantation of bone marrow was 47% compared with 42% after peripheral blood. The 8-year probability of leukemia-free survival was 40% after transplantation of bone marrow and...Continue Reading

References

Aug 1, 1980·The American Journal of Medicine·H M ShulmanE D Thomas
Nov 21, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Mary EapenClaudio Anasetti
Nov 10, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Andrea BacigalupoMary Horowitz
Oct 19, 2012·The New England Journal of Medicine·Claudio AnasettiUNKNOWN Blood and Marrow Transplant Clinical Trials Network
Dec 12, 2012·Bone Marrow Transplantation·R OlssonO Ringden
Apr 16, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Can-Lan SunSmita Bhatia
Sep 26, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Mary EapenRichard E Champlin
May 22, 2017·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Menachem BitanMary Eapen

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Citations

May 28, 2019·Frontiers in Pediatrics·Jessica A NeelyKristin Ammon Shimano
Jun 3, 2021·Journal of Personalized Medicine·Archana RamgopalRamasubramanian Kalpatthi

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