HEMATOPOIETIC RECOVERY AFTER ALLOGENEIC BLOOD STEM-CELL TRANSPLANTATION COMPARED WITH BONE-MARROW TRANSPLANTATION IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES

Purpose: To compare hematopoietic recovery, duration of hospitalizatio n, and 100-day survival in patients who received allogeneic-blood stem cells (BSC) or conventional allogeneic bone marrow transplantation (B MT). Patients and Methods: From December 1994 to August 1995, 21 patie nts participated in a phase II study of allogeneic BSC transplantation , Cells mobilized with granulocyte colony-stimulating factor (G-CSF; 5 mu g/kg/d) were collected from human leukocyte antigen (HLA)-matched related donors and cryopreserved. Graft-versus-host disease (GVHD) pro phylaxis consisted of cyclosporine and methotrexate. G-CSF (10 mu g/kg /d) was administered posttransplant. The outcomes were compared with 2 2 identically treated historical patients who received allogeneic BMT. Results: The median infused CD34(+) cell and granulocyte-macrophage c olony-forming unit (CFU-GM) content were 7.73 x 10(6)/kg and 41.6 x 10 (4)/kg, respectively, The median time to a neutrophil count greater th an 500/mu L wets 11 days after BSC and 16.5 days alter BMT (P = .0003) . A trend toward faster platelet and BBC recovery after BSC was observ ed, BSC patients received fewer platelet transfusions: 10 versus 19 (P = .015). The median length of hospitalization was shorter after BSC t ransplantation: 25 versus 31.5 days (P = .0243). The 100-day survival rates were similar: 83% after BSC and 75% after BMT (P = .3585). The i ncidence of acute GVHD grade II to IV was 57% and 45% for BSC and BMT, respectively (P = .4654). Conclusion: In comparison to BMT, allogenei c BSC transplantation may result in faster hematopoietic recovery, sho rter hospital stay, and similar early survival. Whether allogeneic BSC are superior to bone marrow needs to be determined in randomized tria ls. (C) 1997 by American Society of Clinical Oncology.