TY - JOUR
T1 - Comparison of outcomes after transplantation of g-csf-stimulated bone marrow grafts versus bone marrow or peripheral blood grafts from hla-matched sibling donors for patients with severe aplastic anemia
AU - Chu, Roland
AU - Brazauskas, Ruta
AU - Kan, Fangyu
AU - Bashey, Asad
AU - Bredeson, Christopher
AU - Camitta, Bruce
AU - Chiang, Kuang Yueh
AU - Frangoul, Haydar
AU - Gale, Robert Peter
AU - Gee, Adrian
AU - George, Biju
AU - Goldman, Frederick D.
AU - Gross, Thomas G.
AU - Gupta, Vikas
AU - Hale, Gregory A.
AU - Isola, Luis
AU - Ispizua, Alvaro Urbano
AU - Lazarus, Hillard
AU - Marsh, Judith
AU - Russell, James
AU - Sabloff, Mitchell
AU - Waller, Edmund K.
AU - Eapen, Mary
N1 - Funding Information:
Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS) ; 2 grants, N00014-06-1-0704 and N00014-08-1-0058 , from the Office of Naval Research ; and grants from AABB ; Aetna ; American Society for Blood and Marrow Transplantation ; Amgen, Inc .; anonymous donation to the Medical College of Wisconsin ; Astellas Pharma US, Inc .; Baxter International, Inc .; Bayer HealthCare Pharmaceuticals ; Be the Match Foundation ; Biogen IDEC; BioMarin Pharmaceutical, Inc .; Biovitrum AB; Blood Center of Wisconsin ; Blue Cross and Blue Shield Association ; Bone Marrow Foundation ; Buchanan Family Foundation ; Canadian Blood and Marrow Transplant Group ; CaridianBCT ; Celgene Corporation ; CellGenix , GmbH ; Centers for Disease Control and Prevention ; Children’s Leukemia Research Association ; ClinImmune Labs ; CTI Clinical Trial and Consulting Services ; Cubist Pharmaceuticals ; Cylex Inc .; CytoTherm ; DOR BioPharma, Inc .; Dynal Biotech, an Invitrogen Company; Eisai, Inc .; Enzon Pharmaceuticals, Inc. ; European Group for Blood and Marrow Transplantation ; Gamida Cell, Ltd. ; GE Healthcare ; Genentech, Inc. ; Genzyme Corporation; Histogenetics, Inc .; HKS Medical Information Systems; Hospira, Inc .; Infectious Diseases Society of America ; Kiadis Pharma; Kirin Brewery Co., Ltd. ; The Leukemia & Lymphoma Society; Merck & Company ; The Medical College of Wisconsin ; MGI Pharma, Inc. ; Michigan Community Blood Centers ; Millennium Pharmaceuticals, Inc. ; Miller Pharmacal Group ; Milliman USA, Inc. ; Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Nature Publishing Group ; New York Blood Center ; Novartis Oncology ; Oncology Nursing Society; Osiris Therapeutics, Inc .; Otsuka America Pharmaceutical, Inc. ; Pall Life Sciences; Pfizer Inc ; Saladax Biomedical, Inc. ; Schering Corporation ; Society for Healthcare Epidemiology of America; Soligenix, Inc. ; StemCyte, Inc .; StemSoft Software, Inc .; Sysmex America, Inc .; THERAKOS, Inc .; Thermogenesis Corporation ; Vidacare Corporation ; Vion Pharmaceuticals, Inc. ; ViraCor Laboratories; ViroPharma, Inc .; and Wellpoint, Inc . The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the U.S. Government.
PY - 2011/7
Y1 - 2011/7
N2 - We compared outcomes of patients with severe aplastic anemia (SAA) who received granulocyte-colony stimulating factor (G-CSF)-stimulated bone marrow (G-BM) (n = 78), unstimulated bone marrow (BM) (n = 547), or peripheral blood progenitor cells (PBPC) (n = 134) from an HLA-matched sibling. Transplantations occurred in 1997 to 2003. Rates of neutrophil and platelet recovery were not different among the 3 treatment groups. Grade 2-4 acute graft-versus-host disease (aGVHD) (relative risk [RR] = 0.82, P = .539), grade 3-4 aGVHD (RR = 0.74, P = .535), and chronic GVHD (cGVHD) (RR = 1.56, P = .229) were similar after G-BM and BM transplants. Grade 2-4 aGVHD (RR = 2.37, P = .012) but not grade 3-4 aGVHD (RR = 1.66, P = .323) and cGVHD (RR = 5.09, P < .001) were higher after PBPC transplants compared to G-BM. Grade 2-4 (RR = 2.90, P < .001), grade 3-4 (RR = 2.24, P = .009) aGVHD and cGVHD (RR = 3.26, P < .001) were higher after PBPC transplants compared to BM. Mortality risks were lower after transplantation of BM compared to G-BM (RR = 0.63, P = .05). These data suggest no advantage to using G-BM and the observed higher rates of aGVHD and cGVHD in PBPC recipients warrants cautious use of this graft source for SAA. Taken together, BM is the preferred graft for HLA-matched sibling transplants for SAA.
AB - We compared outcomes of patients with severe aplastic anemia (SAA) who received granulocyte-colony stimulating factor (G-CSF)-stimulated bone marrow (G-BM) (n = 78), unstimulated bone marrow (BM) (n = 547), or peripheral blood progenitor cells (PBPC) (n = 134) from an HLA-matched sibling. Transplantations occurred in 1997 to 2003. Rates of neutrophil and platelet recovery were not different among the 3 treatment groups. Grade 2-4 acute graft-versus-host disease (aGVHD) (relative risk [RR] = 0.82, P = .539), grade 3-4 aGVHD (RR = 0.74, P = .535), and chronic GVHD (cGVHD) (RR = 1.56, P = .229) were similar after G-BM and BM transplants. Grade 2-4 aGVHD (RR = 2.37, P = .012) but not grade 3-4 aGVHD (RR = 1.66, P = .323) and cGVHD (RR = 5.09, P < .001) were higher after PBPC transplants compared to G-BM. Grade 2-4 (RR = 2.90, P < .001), grade 3-4 (RR = 2.24, P = .009) aGVHD and cGVHD (RR = 3.26, P < .001) were higher after PBPC transplants compared to BM. Mortality risks were lower after transplantation of BM compared to G-BM (RR = 0.63, P = .05). These data suggest no advantage to using G-BM and the observed higher rates of aGVHD and cGVHD in PBPC recipients warrants cautious use of this graft source for SAA. Taken together, BM is the preferred graft for HLA-matched sibling transplants for SAA.
KW - Aplastic anemia
KW - G-mobilized BM
KW - GVHD
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=79958756704&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2010.10.029
DO - 10.1016/j.bbmt.2010.10.029
M3 - Article
C2 - 21034842
AN - SCOPUS:79958756704
SN - 1083-8791
VL - 17
SP - 1018
EP - 1024
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 7
ER -