ALLOGENEIC BLOOD-CELL TRANSPLANTS FOR HEMATOLOGICAL MALIGNANCY - PRELIMINARY COMPARISON OF OUTCOMES WITH BONE-MARROW TRANSPLANTATION

Twenty-six patients with haematological malignancy received cryopreser ved but otherwise unmanipulated blood cell transplants (BCT) from five - or six-antigen matched siblings in whom progenitor cells had been mo bilized by G-CSF; Outcomes were compared with a historical control gro up of 26 BMT patients matched for age and disease status, Granulocyte counts recovered to 0.5 x 10(9)/I in a median of 16 days after BCT com pared with 21.5 days after BMT (P = 0.0002), Platelet counts, unsuppor ted for 3 days, reached 20 x 10(9)/I in a median of 14 days vs 20.5 da ys (P = 0.0003) after BCT compared with BMT in those patients who engr afted, In the BCT and BMT groups, respectively, the risk of grade LI-I V acute GVHD was 37 vs 21% (P = 0.16) and of chronic GVHD at 1 year 53 vs 48% (P = 0.9), There was no significant difference in red cell tra nsfusions but BCT patients required fewer platelet transfusions (media n 3 vs 5, P = 0.015) and fewer days in hospital (20.5 vs 25, P = 0.02) , These results indicate that allogeneic BCT from matched and partiall y mismatched family donors result in faster engraftment than BMT witho ut a significant increase in GVHD. Allogeneic BCT may prove to be a mo re tolerable procedure than BMT for both donor and recipient and there are indications of improved cost-effectiveness.