O. Ringden et al., Peripheral blood stem cell transplantation from unrelated donors: A comparison with marrow transplantation, BLOOD, 94(2), 1999, pp. 455-464
Peripheral blood stem cell (PBSC) transplants from HLA-A, -B, and -DR compa
tible unrelated donors (n = 45) were compared with bone marrow (BM; BM grou
p, n = 45). Eighteen patients received CD34-selected PBSC (CD34 group). The
PBSCs contained more mononuclear cells, CD34(+), CD3(+), and CD56(+) cells
compared with marrow (P < .001). Engraftment was achieved in all 45 patien
ts in the BM group, in 43 of 45 (95%) in the PBSC group, and in 14 of 18 (7
8%) in the CD34 group (P < .01). In multivariate analysis, a short time to
absolute neutrophil count (ANC) equal to 0.5 x 10(9)/L was associated with
the PBSC/CD34 groups (P < .001) and granulocyte colony-stimulating factor (
G-CSF) treatment (P = .017). A short time to platelets equal to 50 x 10(9)/
L was associated with PBSC (P = .003) and no methotrexate (P = .015). Grade
s II-IV acute graft-versus-host disease (GVHD) was 20% in the BM controls,
30% in the PBSC group, and 18% in the CD34 group (not significant [NS]). Th
e probability of chronic GVHD was 85% in the BM group, 59% in the PBSC grou
p, and 0% in the CD34 group (P < .01). One-year transplant-related mortalit
y was 21% and 27% and survival was 53% and 54% in the BM and PBSC groups, r
espectively (NS). The 2-year relapse-free survival was 41% and 46% in the t
wo groups, respectively. (C) 1999 by The American Society of Hematology.