Schrezenmeier Hubert, Passweg Jakob R, Marsh Judith C W, Bacigalupo Andrea, Bredeson Christopher N, Bullorsky Eduardo, Camitta Bruce M, Champlin Richard E, Gale Robert Peter, Fuhrer Monika, Klein John P, Locasciulli Anna, Oneto Rosi, Schattenberg Antonius V M B, Socie Gerard, Eapen Mary
Institute of Clinical Transfusion Medicine and Immunogenetics, University of Ulm, Germany.
Blood. 2007 Aug 15;110(4):1397-400. doi: 10.1182/blood-2007-03-081596. Epub 2007 May 2.
We analyzed the outcome of 692 patients with severe aplastic anemia (SAA) receiving transplants from HLA-matched siblings. A total of 134 grafts were peripheral blood progenitor cell (PBPC) grafts, and 558 were bone marrow (BM) grafts. Rates of hematopoietic recovery and grades 2 to 4 chronic graft-versus-host disease (GVHD) were similar after PBPC and BM transplantations regardless of age at transplantation. In patients older than 20 years, chronic GVHD and overall mortality rates were similar after PBPC and BM transplantations. In patients younger than 20 years, rates of chronic GVHD (relative risk [RR] 2.82; P = .002) and overall mortality (RR 2.04; P = .024) were higher after transplantation of PBPCs than after transplantation of BM. In younger patients, the 5-year probabilities of overall survival were 73% and 85% after PBPC and BM transplantations, respectively. Corresponding probabilities for older patients were 52% and 64%. These data indicate that BM grafts are preferred to PBPC grafts in young patients undergoing HLA-matched sibling donor transplantation for SAA.
我们分析了692例接受人类白细胞抗原（HLA）匹配同胞供者移植的重型再生障碍性贫血（SAA）患者的预后情况。共有134例移植物为外周血祖细胞（PBPC）移植物，558例为骨髓（BM）移植物。无论移植时的年龄如何，PBPC移植和BM移植后的造血恢复率以及2至4级慢性移植物抗宿主病（GVHD）的发生率相似。在年龄大于20岁的患者中，PBPC移植和BM移植后的慢性GVHD和总死亡率相似。在年龄小于20岁的患者中，PBPC移植后的慢性GVHD发生率（相对危险度[RR] 2.82；P = 0.002）和总死亡率（RR 2.04；P = 0.024）高于BM移植后。在年轻患者中，PBPC移植和BM移植后的5年总生存率分别为73%和85%。老年患者的相应概率分别为52%和64%。这些数据表明，在接受HLA匹配同胞供者移植治疗SAA的年轻患者中，BM移植物优于PBPC移植物。
