Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT

Increasing numbers of patients are receiving reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation. We hypothesized that the use of bone marrow graft might decrease the risk of graft-versus-host disease compared to peripheral blood after reduced intensity conditio...

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Autores: Savani, Bipin N., Labopin, Myriam, Blaise, Didier, Niederwieser, Dietger, Ciceri, Fabio, Ganser, Arnold, Arnold, Renate, Afanasyev, Boris, Vigouroux, Stephane, Milpied, Noel, Hallek, Michael, Cornelissen, Jan J., Schwerdtfeger, Rainer, Polge, Emmanuelle, Baron, Frédéric, Esteve Reyner, Jordi, Gorin, Norbert C., Schmid, Christoph, Giebel, Sebastian, Mohty, Mohamad, Nagler, Arnon
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/118273
Acesso em linha:https://hdl.handle.net/2445/118273
Access Level:acceso abierto
Palavra-chave:Leucèmia
Medul·la òssia
Cèl·lules mare
Leukemia
Bone marrow
Stem cells
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spelling Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMTSavani, Bipin N.Labopin, MyriamBlaise, DidierNiederwieser, DietgerCiceri, FabioGanser, ArnoldArnold, RenateAfanasyev, BorisVigouroux, StephaneMilpied, NoelHallek, MichaelCornelissen, Jan J.Schwerdtfeger, RainerPolge, EmmanuelleBaron, FrédéricEsteve Reyner, JordiGorin, Norbert C.Schmid, ChristophGiebel, SebastianMohty, MohamadNagler, ArnonLeucèmiaMedul·la òssiaCèl·lules mareLeukemiaBone marrowStem cellsIncreasing numbers of patients are receiving reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation. We hypothesized that the use of bone marrow graft might decrease the risk of graft-versus-host disease compared to peripheral blood after reduced intensity conditioning regimens without compromising graft-versus-leukemia effects. Patients who underwent reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation from 2000 to 2012 for acute leukemia, and who were reported to the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation were included in the study. Eight hundred and thirty-seven patients receiving bone marrow grafts were compared with 9011 peripheral blood transplant recipients after reduced intensity conditioning regimen. Median follow up of surviving patients was 27 months. Cumulative incidence of engraftment (neutrophil ≥0.5×10(9)/L at day 60) was lower in bone marrow recipients: 88% versus 95% (P<0.0001). Grade II to IV acute graft-versus-host disease was lower in bone marrow recipients: 19% versus 24% for peripheral blood (P=0.005). In multivariate analysis, after adjusting for differences between both groups, overall survival [Hazard Ratio (HR) 0.90; P=0.05] and leukemia-free survival (HR 0.88; P=0.01) were higher in patients transplanted with peripheral blood compared to bone marrow grafts. Furthermore, peripheral blood graft was also associated with decreased risk of relapse (HR 0.78; P=0.0001). There was no significant difference in non-relapse mortality between recipients of bone marrow and peripheral blood grafts, and chronic graft-versus-host disease was significantly higher after peripheral blood grafts (HR 1.38; P<0.0001). Despite the limitation of a retrospective registry-based study, we found that peripheral blood grafts after reduced intensity conditioning regimens had better overall and leukemia-free survival than bone marrow grafts. However, there is an increase in chronic graft-versus-host disease after peripheral blood grafts. Long-term follow up is needed to clarify whether chronic graft-versus-host disease might increase the risk of late morbidity and mortality.Ferrata Storti Foundation2017201720162017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion7 p.application/pdfhttps://hdl.handle.net/2445/118273Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3324/haematol.2015.135699Haematologica, 2016, vol. 101, num. 2, p. 256-262https://doi.org/10.3324/haematol.2015.135699(c) Ferrata Storti Foundation, 2016info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1182732026-05-29T05:05:01Z
dc.title.none.fl_str_mv Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
title Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
spellingShingle Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
Savani, Bipin N.
Leucèmia
Medul·la òssia
Cèl·lules mare
Leukemia
Bone marrow
Stem cells
title_short Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
title_full Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
title_fullStr Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
title_full_unstemmed Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
title_sort Peripheral blood stem cell graft compared to bone marrow after reduced intensity conditioning regimens for acute leukemia: a report from the ALWP of the EBMT
dc.creator.none.fl_str_mv Savani, Bipin N.
Labopin, Myriam
Blaise, Didier
Niederwieser, Dietger
Ciceri, Fabio
Ganser, Arnold
Arnold, Renate
Afanasyev, Boris
Vigouroux, Stephane
Milpied, Noel
Hallek, Michael
Cornelissen, Jan J.
Schwerdtfeger, Rainer
Polge, Emmanuelle
Baron, Frédéric
Esteve Reyner, Jordi
Gorin, Norbert C.
Schmid, Christoph
Giebel, Sebastian
Mohty, Mohamad
Nagler, Arnon
author Savani, Bipin N.
author_facet Savani, Bipin N.
Labopin, Myriam
Blaise, Didier
Niederwieser, Dietger
Ciceri, Fabio
Ganser, Arnold
Arnold, Renate
Afanasyev, Boris
Vigouroux, Stephane
Milpied, Noel
Hallek, Michael
Cornelissen, Jan J.
Schwerdtfeger, Rainer
Polge, Emmanuelle
Baron, Frédéric
Esteve Reyner, Jordi
Gorin, Norbert C.
Schmid, Christoph
Giebel, Sebastian
Mohty, Mohamad
Nagler, Arnon
author_role author
author2 Labopin, Myriam
Blaise, Didier
Niederwieser, Dietger
Ciceri, Fabio
Ganser, Arnold
Arnold, Renate
Afanasyev, Boris
Vigouroux, Stephane
Milpied, Noel
Hallek, Michael
Cornelissen, Jan J.
Schwerdtfeger, Rainer
Polge, Emmanuelle
Baron, Frédéric
Esteve Reyner, Jordi
Gorin, Norbert C.
Schmid, Christoph
Giebel, Sebastian
Mohty, Mohamad
Nagler, Arnon
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Leucèmia
Medul·la òssia
Cèl·lules mare
Leukemia
Bone marrow
Stem cells
topic Leucèmia
Medul·la òssia
Cèl·lules mare
Leukemia
Bone marrow
Stem cells
description Increasing numbers of patients are receiving reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation. We hypothesized that the use of bone marrow graft might decrease the risk of graft-versus-host disease compared to peripheral blood after reduced intensity conditioning regimens without compromising graft-versus-leukemia effects. Patients who underwent reduced intensity conditioning regimen allogeneic hematopoietic stem cell transplantation from 2000 to 2012 for acute leukemia, and who were reported to the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation were included in the study. Eight hundred and thirty-seven patients receiving bone marrow grafts were compared with 9011 peripheral blood transplant recipients after reduced intensity conditioning regimen. Median follow up of surviving patients was 27 months. Cumulative incidence of engraftment (neutrophil ≥0.5×10(9)/L at day 60) was lower in bone marrow recipients: 88% versus 95% (P<0.0001). Grade II to IV acute graft-versus-host disease was lower in bone marrow recipients: 19% versus 24% for peripheral blood (P=0.005). In multivariate analysis, after adjusting for differences between both groups, overall survival [Hazard Ratio (HR) 0.90; P=0.05] and leukemia-free survival (HR 0.88; P=0.01) were higher in patients transplanted with peripheral blood compared to bone marrow grafts. Furthermore, peripheral blood graft was also associated with decreased risk of relapse (HR 0.78; P=0.0001). There was no significant difference in non-relapse mortality between recipients of bone marrow and peripheral blood grafts, and chronic graft-versus-host disease was significantly higher after peripheral blood grafts (HR 1.38; P<0.0001). Despite the limitation of a retrospective registry-based study, we found that peripheral blood grafts after reduced intensity conditioning regimens had better overall and leukemia-free survival than bone marrow grafts. However, there is an increase in chronic graft-versus-host disease after peripheral blood grafts. Long-term follow up is needed to clarify whether chronic graft-versus-host disease might increase the risk of late morbidity and mortality.
publishDate 2016
dc.date.none.fl_str_mv 2016
2017
2017
2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/118273
url https://hdl.handle.net/2445/118273
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3324/haematol.2015.135699
Haematologica, 2016, vol. 101, num. 2, p. 256-262
https://doi.org/10.3324/haematol.2015.135699
dc.rights.none.fl_str_mv (c) Ferrata Storti Foundation, 2016
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Ferrata Storti Foundation, 2016
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 7 p.
application/pdf
dc.publisher.none.fl_str_mv Ferrata Storti Foundation
publisher.none.fl_str_mv Ferrata Storti Foundation
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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