Cornelissen J J, Fibbe W E, Schattenberg A V, Petersen E J, Willemze R, de Witte T J, Löwenberg B, Verdonck L F, vd Biezen A, Brand R
Department of Hematology, University Hospital Rotterdam/Dijkzigt and Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Bone Marrow Transplant. 1998 Jun;21 Suppl 3:S66-70.
Retrospectively, a cohort of 43 hematological patients receiving an allogeneic T cell-depleted (TCD)-PBSCT between 1994 and 1997, was compared to a cohort of 435 patients, who received an allogeneic TCD-BMT between 1990 and 1996. Both cohorts were comparable with respect to diagnosis, risk status, age and sex. PB grafts contained four to five times more hematopoietic progenitor cells and T cells as compared to BM grafts. T cell depletion was performed by either elutriation, CD34 selection, E-rosetting, or Campath serotherapy. Conditioning was cyclophosphamide/TBI in the majority of patients of both cohorts. All patients received cyclosporin A as GVHD prophylaxis until day 90 post-transplant. Engraftment was significantly faster in the PBPCT cohort with a median time to neutrophil recovery (>0.5 x 10(9)/l) of 16 vs 21 days in the BMT cohort (P = 0.0009). Platelet recovery to 50 x 10(9)/l was 16 vs 34 days for the PB and BM cohort respectively (P < 0.0001). A median percentage of 76% of BMT patients recovered to 50 within 100 days post-BMT vs 91% of patients receiving a PB graft. The incidence of acute GVHD grades II, III and IV was similar in both cohorts. In contrast, the probability of developing chronic GVHD was 21% in the BM cohort vs 37% in the PB cohort. Relapse incidence was reduced in the PB cohort (9 vs 29%), while treatment-related mortality was not different for both cohorts. These favorable results require confirmation by a prospective randomized trial, which is currently being performed by several European centers.
回顾性地，将1994年至1997年间接受异基因T细胞去除（TCD）-外周血干细胞移植（PBSCT）的43例血液学患者队列，与1990年至1996年间接受异基因TCD-骨髓移植（BMT）的435例患者队列进行比较。两个队列在诊断、风险状态、年龄和性别方面具有可比性。与骨髓移植物相比，外周血移植物中的造血祖细胞和T细胞多四至五倍。通过淘洗、CD34选择、E花环形成或Campath血清疗法进行T细胞去除。两个队列的大多数患者的预处理方案为环磷酰胺/全身照射（TBI）。所有患者在移植后90天内均接受环孢素A预防移植物抗宿主病（GVHD）。外周血干细胞移植队列的植入明显更快，中性粒细胞恢复至中位数时间（>0.5×10⁹/L）为16天，而骨髓移植队列中为21天（P = 0.0009）。外周血和骨髓队列中血小板恢复至50×10⁹/L的时间分别为16天和34天（P < 0.0001）。骨髓移植患者中有76%的中位数百分比在骨髓移植后100天内恢复至50，而接受外周血移植物的患者为91%。两个队列中急性GVHD II、III和IV级的发生率相似。相比之下，骨髓队列中发生慢性GVHD的概率为21%，而外周血队列中为37%。外周血队列中的复发率降低（9%对29%），而两个队列的治疗相关死亡率无差异。这些良好结果需要前瞻性随机试验予以证实，目前几个欧洲中心正在进行该试验。
