Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: A propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry

Koji Nagafuji, Keitaro Matsuo, Takanori Teshima, Shin Ichiro Mori, Hisashi Sakamaki, Michihiro Hidaka, Hiroyasu Ogawa, Yoshihisa Kodera, Yoshinobu Kanda, Atsuo Maruta, Takehiko Mori, Fumiaki Yoshiba, Tatsuo Ichinohe, Masanobu Kasai, Yoshifusa Takatsuka, Kohmei Kubo, Hiroshi Sao, Yoshiko Atsuta, Ritsuro Suzuki, Takashi YoshidaMasahiro Tsuchida, Mine Harada

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28 Citations (Scopus)

Abstract

We retrospectively analyzed the results of 707 adult patients who underwent myeloablative peripheral blood stem cell transplantation (PBSCT) (n = 365) and myeloablative bone marrow transplantation (BMT) (n = 342) for leukemia from HLA-identical sibling donors between 2000 and 2005 using the propensity score method. The results were obtained from the Japan Society for Hematopoietic Cell Transplantation registry. Multivariate Cox analysis showed that PBSCT was associated with lower overall survival (OS) in standard-risk patients [adjusted hazard ratio (aHR) = 1.83; 95% confidence interval (CI) 1.04-3.23; P = 0.036], but not in high-risk patients (aHR = 1.11; 95% CI 0.76-1.61; P = 0.599). Hematopoietic recovery was significantly faster after PBSCT. The risk of acquiring grade III-IV acute graft-versus-host disease (GVHD) (aHR = 2.23; P = 0.040) and extensive chronic GVHD (aHR = 1.93; P = 0.001) were significantly higher after PBSCT. PBSCT was associated with higher non-relapse mortality in standard-risk patients (aHR = 2.30; 95% CI 1.08-4.88; P = 0.030), but not in high-risk patients (aHR = 1.29; 95% CI 0.65-2.54; P = 0.468). Relapse after transplantation did not differ between PBSCT and BMT either in standard-risk group or in high-risk group (aHR = 1.17; 95% CI 0.55-2.52; P = 0.684 and aHR = 0.81; 95% CI 0.52-1.28; P = 0.370, respectively). In this retrospective analysis, OS was significantly lower after PBSCT in standard-risk patients, but not in high-risk patients. PBSCT was associated with significant risks of grade III-IV acute GVHD and extensive chronic GVHD.

Original languageEnglish
Pages (from-to)855-864
Number of pages10
JournalInternational journal of hematology
Volume91
Issue number5
DOIs
Publication statusPublished - 2010 Jun 1

Keywords

  • Allogeneic
  • Bone marrow transplantation
  • Graft-versus-host disease
  • Peripheral blood stem cell transplantation

ASJC Scopus subject areas

  • Hematology

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    Nagafuji, K., Matsuo, K., Teshima, T., Mori, S. I., Sakamaki, H., Hidaka, M., Ogawa, H., Kodera, Y., Kanda, Y., Maruta, A., Mori, T., Yoshiba, F., Ichinohe, T., Kasai, M., Takatsuka, Y., Kubo, K., Sao, H., Atsuta, Y., Suzuki, R., ... Harada, M. (2010). Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: A propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry. International journal of hematology, 91(5), 855-864. https://doi.org/10.1007/s12185-010-0581-1