Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 25, Issue 2, Pages 270-278Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2018.09.004
Keywords
bone marrow; peripheral blood; unrelated donor hematopoietic; cell transplant
Categories
Funding
- Public Health Service from National Cancer Institute (NCI) [5U24CA076518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases
- NHLBI [4U10HL069294]
- NCI
- Health Resources and Services Administration [HHSH250201200016C]
- Office of Naval Research [N00014-17-1-2388, N0014-17-1-2850]
- Actinium Pharmaceuticals
- Amgen
- Amneal Biosciences
- Angiocrine Bioscience
- Astellas Pharma US
- Atara Biotherapeutics
- Be the Match Foundation
- bluebird bio
- Bristol Myers Squibb Oncology
- Celgene
- Cerus
- Chimerix
- Fred Hutchinson Cancer Research Center
- Gamida Cell
- Gilead Sciences
- HistoGenetics
- Immucor
- Incyte
- Janssen Scientific Affairs
- Jazz Pharmaceuticals
- Juno Therapeutics
- Karyopharm Therapeutics
- Kite Pharma
- Medac
- MedImmune
- Medical College of Wisconsin
- Mediware
- Merck Co
- Mesoblast
- MesoScale Diagnostics
- Millennium, the Takeda Oncology Company
- Miltenyi Biotec
- National Marrow Donor Program
- Neovii Biotech NA
- Novartis Pharmaceuticals
- Otsuka Pharmaceuticals
- PCORI
- Pfizer
- Pharmacyclics
- PIRCHE
- Sanofi Genzyme
- Seattle Genetics
- Shire
- Spectrum Pharmaceuticals
- St. Baldrick's Foundation
- Sunesis Pharmaceuticals
- Swedish Orphan Biovitrum
- Takeda Oncology
- Telomere Diagnostics
- University of Minnesota
- NATIONAL CANCER INSTITUTE [ZIACP010190] Funding Source: NIH RePORTER
Ask authors/readers for more resources
Peripheral blood (PB) and bone marrow (BM) from unrelated donors can serve as a graft source for hematopoietic cell transplantation (HCT). Currently, PB is most commonly used in roughly 80% of adult recipients. Determining the long-term impact of graft source on outcomes would inform this decision. Data collected by the Center for International Blood and Marrow Transplant Research from 5200 adult recipients of a first HCT from an 8/8 or 7/8 HLA antigen-matched unrelated donor for treatment of acute leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome between 2001 and 2011 were analyzed to determine the impact of graft source on graft-versus -host disease (GVHD) relapse-free survival (GRFS), defined as freedom from grade III/IV acute GVHD, chronic GVHD requiring immunosuppressive therapy, relapse, and death, and overall survival. GRFS at 2 years was superior in BM recipients compared with PB recipients (16%; 95% confidence interval [Cl], 14% to 18% versus 10%; 95% CI, 8% to 11%; P <.0001) in the 8/8 HLA-matched cohort and 7/8 HLA-matched cohort (11%; 95% Cl, 8% to 14% versus 5%; 95% Cl, 4% to 7%; P=.001). With 8/8 HLA-matched unrelated donors, overall survival at 5 years was superior in recipients of BM (43%; 95% Cl, 40% to 46% versus 38%; 95% Cl, 36% to 40%; P =.014). The inferior 5-year survival in the PB cohort was attributable to a higher frequency of deaths while in remission compared with the BM cohort. For recipients of 7/8 HLA-matched grafts, survival at 5 years was similar in BM recipients and PB recipients (32% versus 29%; P=.329). BM grafts are associated with improved long-term GRFS and overall survival in recipients of matched unrelated donor HCT and should be considered the unrelated allograft of choice, when available, for adults with acute leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome. (C) 2018 American Society for Blood and Marrow Transplantation.
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