Recently, PBSC have become more frequently used in place of BM as a source of allogeneic hematopoietic stem cell transplantation. PBSC samples contain greater number of both progenitors and lymphocytes compared to BM. Several studies have shown that the incidence of acute GVHD (aGVHD) is similar between PBSCT and BMT. However, it must also be compared in Japanese recipients, because it has been known that the incidence of aGVHD is lower and the character of aGVHD may be different in BM recipients in Japan compared to those in European/American countries. In addition, it has not been clarified whether the organ distribution of acute GVHD is altered by the use of PBSC. In order to evaluate these issues, we compared the clinical courses of 28 PBSC recipients with those of 27 BM recipients who received allogeneic HSCT at NCCH between 1996 and 2000. All received allogeneic graft from an HLA-identical sibling or a relative with one HLAmismatched antigen for the underlying hematological malignancies. The median age was 40 years in PBSC recipients and 37 years in BM recipients. The preparative regimen was busulfan-based regimen or TBI-based regimen. Prophylaxis for GVHD was performed with cyclosporine A and short-term methotrexate. Twenty-five of 27 BM recipients and all 28 PBSC recipients had engraftment and enrolled in the following analyses. The frequency of grade II-IV acute GVHD after transplantation was 46% in PBSC recipients and 36% in BM recipients (p=0.442). The onset of acute GVHD and the severity of acute GVHD were not significantly different (p=0.60I and 0.312, respectively). Next, we evaluated the organ distribution of acute GVHD by analyzing the incidence of acute GVHD in the skin, gut, and liver lesions separately, with no significant difference (skin p=0.305, gut p=0.730, liver p=0.650). In conclusion, we could not detect any significant difference in the incidences of acute GVHD or its organ distribution between allogeneic BM and PBSC recipients in Japan. However, a prospective randomized study with a larger number of patients is still required to clarify this issue.
|Issue number||11 PART II|
|Publication status||Published - 2000 Dec 1|
ASJC Scopus subject areas
- Cell Biology