ALLOGENEIC BONE-MARROW OR PERIPHERAL-BLOOD CELL TRANSPLANTS IN ADULTSWITH HEMATOLOGIC MALIGNANCIES - A SINGLE-CENTER EXPERIENCE

This is a retrospective study of 97 patients who received either allog eneic bone marrow transplant (BMT) (n=52) or peripheral blood cell tra nsplant (PBCT) (n=45) at our institution from human leukocyte antigen (HLA)-identical sibling donors between January 1994 and January 1997. The two groups were comparable with respect to diagnosis, age, sex, in terval from diagnosis, and disease phase. They were prepared with cycl ophosphamide (CY) and fractionated total-body irradiation (TBI) (n=51) or CY and thiotepa (n=46). Graft-vs.-host disease (GVHD) prophylaxis consisted of cyclosporin A and methotrexate. Patients who received PBC T exhibited faster neutrophil engraftment (day 14 vs, day 16, p = 0.00 2) than those in the BMT group, as well as higher platelet counts on d ay 20 (32x10(9)/kg vs. 21x10(9)/kg, p = 0.001), but graft function as assessed by platelet counts on days 50, 100, and thereafter was compar able. The number of days spent in the hospital, days on intravenous an tibiotics, and days of fever were lower in the PBCT group, but not sig nificantly. Acute GVHD, chronic GVHD, and cytomegalovirus infections w ere comparable between the two groups. The overall actuarial 3-year tr ansplant-related mortality (TRM) rate for BMT vs. PBCT patients was 20 vs. 33% (p = 0.1), the survival rate was 53 vs. 48% (p = 0.3), and th e relapse rate was 42 vs. 43% (p = 0.8). For patients in first complet e remission, these figures were TRM 12 vs. 22% (P = 0.2), survival rat e 75 vs. 70% (P = 0.4) and relapse rate 31 vs. 9% (p = 0.4), respectiv ely, for the BMT and PBCT groups. These data suggest that the short-te rm outcome of allogeneic PBCT is not significantly different from that of allogeneic BMT in patients with hematologic malignancies. Long-ter m results are not available at present.