Universität zu Köln

Savani, Bipin N., Labopin, Myriam, Blaise, Didier, Niederwieser, Dietger, Ciceri, Fabio, Ganser, Arnold, Arnold, Renate, Afanasyev, Boris, Vigouroux, Stephane, Milpied, Noel ORCID: 0000-0002-5177-014X, Hallek, Michael, Cornelissen, Jan J., Schwerdtfeger, Rainer, Polge, Emmanuelle, Baron, Frederic, Esteve, Jordi, Gorin, Norbert C., Schmid, Christoph, Giebel, Sebastian ORCID: 0000-0002-4827-4401, Mohty, Mohamad and Nagler, Arnon (2016). 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. Haematologica, 101 (2). S. 256 - 263. PAVIA: FERRATA STORTI FOUNDATION. ISSN 0390-6078

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Abstract

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 >= 0.5x10(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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Savani, Bipin N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Labopin, Myriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaise, Didier UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederwieser, Dietger UNSPECIFIED UNSPECIFIED UNSPECIFIED Ciceri, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Ganser, Arnold UNSPECIFIED UNSPECIFIED UNSPECIFIED Arnold, Renate UNSPECIFIED UNSPECIFIED UNSPECIFIED Afanasyev, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Vigouroux, Stephane UNSPECIFIED UNSPECIFIED UNSPECIFIED Milpied, Noel UNSPECIFIED orcid.org/0000-0002-5177-014X UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornelissen, Jan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwerdtfeger, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Polge, Emmanuelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Baron, Frederic UNSPECIFIED UNSPECIFIED UNSPECIFIED Esteve, Jordi UNSPECIFIED UNSPECIFIED UNSPECIFIED Gorin, Norbert C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Giebel, Sebastian UNSPECIFIED orcid.org/0000-0002-4827-4401 UNSPECIFIED Mohty, Mohamad UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Arnon UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-286285
DOI:	10.3324/haematol.2015.135699
Journal or Publication Title:	Haematologica
Volume:	101
Number:	2
Page Range:	S. 256 - 263
Date:	2016
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
ISSN:	0390-6078
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MYELOID-LEUKEMIA; VERSUS-HOST-DISEASE; UNRELATED DONOR TRANSPLANTATION; COMPLETE REMISSION; WORKING PARTY; EUROPEAN GROUP; ALLOGENEIC TRANSPLANTATION; RANDOMIZED-TRIAL; SIBLING DONOR; SURVIVAL Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28628