Li Yuhang, Jiang Min, Xu Chen, Chen Jianlin, Li Botao, Wang Jun, Hu Jiangwei, Ning Hongmei, Chen Hu, Chen Shuiping, Hu Liangding
Center of Hematopoietic Stem Cell Transplantation, 307 Hospital of People's Liberation Army, Beijing 100071, China.
Chin Med J (Engl). 2015 Jan 5;128(1):20-4. doi: 10.4103/0366-6999.147790.
Steady-state bone marrow (SS-BM) and granulocyte colony-stimulating growth factor-primed BM/peripheral blood stem-cell (G-BM/G-PBSC) are the main stem-cell sources used in allogeneic hematopoietic stem-cell transplantation. Here, we evaluated the treatment effects of SS-BM and G-BM/G-PBSC in human leucocyte antigen (HLA)-identical sibling transplantation.
A total of 226 patients (acute myelogenous leukemia-complete remission 1, chronic myelogenous leukemia-chronic phase 1) received SS-BM, G-BM, or G-PBSC from an HLA-identical sibling. Clinical outcomes (graft-versus-host disease [GVHD], overall survival, transplant-related mortality [TRM], and leukemia-free survival [LFS]) were analyzed.
When compared to SS-BM, G-BM gave faster recovery time to neutrophil or platelet (P < 0.05). Incidence of grade III-IV acute GVHD and extensive chronic GVHD (cGVHD) was lower than seen with SS-BM (P < 0.05) and similar to G-PBSC. Although the incidence of cGVHD in the G-BM group was similar to SS-BM, both were lower than G-PBSC (P < 0.05). G-BM and G-PBSC exhibited similar survival, LFS, and TRM, but were significantly different from SS-BM (P < 0.05). There were no significant differences in leukemia relapse rates among the groups (P > 0.05).
G-CSF-primed bone marrow shared the advantages of G-PBSC and SS-BM. We conclude that G-BM is an excellent stem-cell source that may be preferable to G-PBSC or SS-BM in patients receiving HLA-identical sibling hematopoietic stem-cell transplantation.
稳态骨髓（SS - BM）和粒细胞集落刺激因子预处理的骨髓/外周血干细胞（G - BM/G - PBSC）是异基因造血干细胞移植中使用的主要干细胞来源。在此，我们评估了SS - BM和G - BM/G - PBSC在人类白细胞抗原（HLA）匹配的同胞移植中的治疗效果。
总共226例患者（急性髓性白血病完全缓解期1、慢性髓性白血病慢性期1）接受了来自HLA匹配同胞的SS - BM、G - BM或G - PBSC。分析了临床结局（移植物抗宿主病[GVHD]、总生存率、移植相关死亡率[TRM]和无白血病生存率[LFS]）。
与SS - BM相比，G - BM使中性粒细胞或血小板恢复时间更快（P < 0.05）。III - IV级急性GVHD和广泛慢性GVHD（cGVHD）的发生率低于SS - BM（P < 0.05），且与G - PBSC相似。虽然G - BM组cGVHD的发生率与SS - BM相似，但两者均低于G - PBSC（P < 0.05）。G - BM和G - PBSC表现出相似的生存率、LFS和TRM，但与SS - BM有显著差异（P < 0.05）。各组之间白血病复发率无显著差异（P > 0.05）。
粒细胞集落刺激因子预处理的骨髓兼具G - PBSC和SS - BM的优点。我们得出结论，在接受HLA匹配同胞造血干细胞移植的患者中，G - BM是一种优秀的干细胞来源，可能优于G - PBSC或SS - BM。
