Long-term outcomes after transplantation of HLA-identical related G-CSF-mobilized peripheral blood mononuclear cells versus bone marrow.

Publication Type:

Journal Article

Authors:

Mielcarek, Marco; Storer, Barry; Martin, Paul J; Forman, Stephen J; Negrin, Robert S; Flowers, Mary E; Inamoto, Yoshihiro; Chauncey, Thomas R; Storb, Rainer; Appelbaum, Frederick R; Bensinger, William I

Source:

Blood, Volume 119, Issue 11, p.2675-2678 (2012)

Keywords:

2012, Center-Authored Paper, Clinical Research Division, Consortium Authored Paper, February 2012

Abstract:

Between 1996 and 1999, 172 patients (median age, 42 years) with hematologic malignancies were randomly assigned to receive either HLA-identical related bone marrow or G-CSF-mobilized peripheral blood mononuclear cells (G-PBMC) after myeloablative conditioning. Early results showed that transplantation of G-PBMC, compared with marrow, was associated with significantly superior 2-year disease-free survival (DFS) and overall survival (OS). Ten-year follow-up showed a sustained DFS benefit associated with G-PBMC (mortality or relapse hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.4-1.0; p=0.03), although the likelihood of OS was not significantly different between the two groups (mortality HR, 0.75; 95% CI, 0.5-1.2; p=0.20). The 10-year cumulative incidence of chronic GVHD and the duration of systemic immunosuppression were similar in the two groups. In summary, transplantation of HLA-identical related G-PBMC, compared with marrow, was associated with superior short-term and long-term DFS, and there was no evidence that this benefit was outweighed by GVHD-related late mortality.