Randomized trial of bone marrow versus lenograstim-primed blood cell allogeneic transplantation in patients with early-stage leukemia: A report from the Societe Francaise de Greffe de Moelle

Purpose: To compare hematologic recovery in patients receiving allogeneic b lood cell transplantation (BCT) with those receiving allogeneic bone marrow transplantation (BMT). Patients and Methods: One hundred eleven patients with leukemia in the earl y stages and with HLA-matched sibling donors were randomized in this study. One hundred one underwent transplantation, Standard procedures for collect ion and transplantation were used. Patients did not receive prophylactic gr anulocyte colony-stimulating factor after undergoing transplantation. In ad dition to clinical end points being established, a prospective and comparat ive economic evaluation of the first 6 months after transplantation was per formed. Results: Groups were balanced for patient, donor, and transplant characteri stics. Blood cell collection led to the collection of a higher number of CD 34(+) and CD3(+) cells than did bone marrow collection (p < 10(-6)) without reported side effects for the donor. Patients in the BCT group reached pla telet counts of 25 and 50 x 10(9) platelets/L 8 and it days earlier than di d the BMT group (P < 10(-4) and P < 10(-5)), respectively. This resulted in fewer platelet transfusions during the first 180 days after transplantatio n (P = .002) for the former group. The time to reach neutrophil counts of 0 .5 and 1 x 10(9) neutrophils/L was 6 and 7 days shorter, respectively, in t he BCT group than in the BMT group (P < 10(-5)). This quicker hematologic r ecovery was associated with a shorter length of hospitalization and a decre ase in total cost of procedure during the first 6 months. Conclusion: This study establishes that allogeneic BCT results in quicker h ematologic recovery but is associated with a higher occurrence of chronic g raft-versus-host disease. J Clin Oncol 18:537-546. (C) 2000 by American Soc iety of Clinical Oncology.