Campregher Paulo Vidal, Hamerschlak Nelson, Colturato Vergilio Antonio Renzi, Mauad Marcos Augusto, de Souza Mair Pedro, Bouzas Luis Fernando da Silva, Tavares Rita de Cássia B, Barros José Carlos, Chiattone Ricardo, Paz Alessandra, Silla Lucia, Vigorito Afonso Celso, Miranda Eliane, Funke Vaneuza Araújo Moreira, Flowers Mary Evelyn
Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Eur J Haematol. 2015 Nov;95(5):421-5. doi: 10.1111/ejh.12508. Epub 2015 Feb 19.
The objective of this study was to compare the major transplant outcomes between patients receiving hematopoietic stem cell transplantation (HSCT) from bone marrow (BM) or peripheral blood stem cells (PBSC).
All consecutive HSCT patients using BM or PBSC from an HLA-matched related donors for haematological malignancies after high intensity conditioning at seven Brazilian transplant centres between January 2008 and December 2009 were retrospectively evaluated.
In the study period, 334 patients were treated in the centres and included in the evaluation. The cumulative incidence of grades II-IV and III-IV acute graft-versus-host disease (GVHD) at one year was 36.7% and 9.7% for BM recipients and 34.4% and 15.1% for PBSC recipients, respectively (not statistically different). The cumulative incidence of chronic GVHD at three years was 53.7% and 79.8% (HR 1.93; 95% CI 1.38-2.69, P < 0.001) for BM and PBSC, respectively. Median overall survival was 2.85 and 2.39 years for BM and PBSC recipients, respectively (HR 1.19; 95% CI, 0.84-1.68, P = 0.34).
Our results confirm previous findings of increased chronic GVHD incidence in patients receiving PBSC when compared to patients receiving BM as the graft source in HSCT. Acute GVHD incidence, progression-free survival and overall survival were not different between the groups.
本研究的目的是比较接受来自骨髓(BM)或外周血干细胞(PBSC)的造血干细胞移植(HSCT)患者的主要移植结局。
对2008年1月至2009年12月期间在巴西七个移植中心接受高强度预处理后,使用来自HLA匹配的相关供体的BM或PBSC进行血液系统恶性肿瘤治疗的所有连续HSCT患者进行回顾性评估。
在研究期间,334例患者在这些中心接受治疗并纳入评估。BM受者1年时II-IV级和III-IV级急性移植物抗宿主病(GVHD)的累积发生率分别为36.7%和9.7%,PBSC受者分别为34.4%和15.1%(无统计学差异)。BM和PBSC的3年慢性GVHD累积发生率分别为53.7%和79.8%(HR 1.93;95%CI 1.38 - 2.69,P < 0.001)。BM和PBSC受者的中位总生存期分别为2.85年和2.39年(HR 1.19;95%CI 0.84 - 1.68,P = 0.34)。
我们的结果证实了先前的研究发现,即与接受BM作为HSCT移植物来源的患者相比,接受PBSC的患者慢性GVHD发生率增加。两组之间急性GVHD发生率、无进展生存期和总生存期无差异。