Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia

Hiroshi Matsubara, Atsushi Makimoto, Jun Takayama, Takeshi Higa, Takeshi Saito, Yoshinobu Kanda, Ryuji Tanosaki, Shin Mineishi, Mutsuro Ohira, Yoichi Takaue

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The benefits of allogeneic peripheral blood stem/progenitor cell transplantation (PBSCT) over bone marrow transplantation (BMT), if any, have not been seriously evaluated in a pediatric population. We report here our experience with this procedure and demonstrate rapid engraftment to reduce procedure-related complications and enhanced allogeneic immune reaction to reduce leukemic relapse. Methods: The feasibility of PBSCT was reviewed retrospectively. Four patients (2 AML and 2 ALL, aged 8-18 years) underwent allogeneic PBSCT for relapsed leukemia after primary allogeneic BMT (n = 2), for active hepatosplenic fungal abscess (n = 1) or for refractory relapse with conventional chemotherapy (n = 1). Four healthy donors (aged 10-49 years) received granulocyte colony-stimulating factor (G-CSF) 10 μg/kg/day by subcutaneous injection for 5 days. An individualized cytoreductive regimen was used before transplantation. Results: No significant toxicities were observed in normal donors on G-CSF treatment or rat collection of PBSC. After PBSCT, no significant acute toxicities were observed and the median duration to an absolute granulocyte count of 0.5 × 109/l and a platelet count of 20 × 109/l was 16 and 21 days, respectively. Although none of our patients developed acute graft-versus-host disease (GVHD), two developed chronic GVHD involving the liver and skin. Among those who developed chronic GVHD, one died of recurrent disease and another died of pneumonia 235 days after PBSCT. The two remaining patients have been alive without evidence of disease with follow-ups of 193 and 123 days, respectively. Conclusions: Allogeneic PBSCT can be a safe procedure in a pediatric population with fewer acute complications, although the potential risk of G-CSF treatment in normal donors should be seriously weighed against the existing risks of marrow aspiration under general anesthesia. The risk of chronic GVHD may need to be balanced against a possible graft-versus-leukemia benefit in patients at higher risk of leukemic relapse.

Original languageEnglish
Pages (from-to)30-34
Number of pages5
JournalJapanese Journal of Clinical Oncology
Volume31
Issue number1
Publication statusPublished - 2001
Externally publishedYes

Fingerprint

Peripheral Blood Stem Cell Transplantation
Homologous Transplantation
Leukemia
Stem Cells
Bone Marrow
Graft vs Host Disease
Granulocyte Colony-Stimulating Factor
Tissue Donors
Bone Marrow Transplantation
Recurrence
Therapeutics
Pediatrics
Subcutaneous Injections
Platelet Count
Granulocytes
Abscess
General Anesthesia
Population
Peripheral Blood Stem Cells
Pneumonia

Keywords

  • Acute leukemia
  • Allogeneic peripheral blood stem cell transplantation
  • Children
  • Graft-versus-host disease
  • Graft-versus-leukemia

ASJC Scopus subject areas

  • Oncology

Cite this

Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia. / Matsubara, Hiroshi; Makimoto, Atsushi; Takayama, Jun; Higa, Takeshi; Saito, Takeshi; Kanda, Yoshinobu; Tanosaki, Ryuji; Mineishi, Shin; Ohira, Mutsuro; Takaue, Yoichi.

In: Japanese Journal of Clinical Oncology, Vol. 31, No. 1, 2001, p. 30-34.

Research output: Contribution to journalArticle

Matsubara, Hiroshi ; Makimoto, Atsushi ; Takayama, Jun ; Higa, Takeshi ; Saito, Takeshi ; Kanda, Yoshinobu ; Tanosaki, Ryuji ; Mineishi, Shin ; Ohira, Mutsuro ; Takaue, Yoichi. / Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia. In: Japanese Journal of Clinical Oncology. 2001 ; Vol. 31, No. 1. pp. 30-34.
@article{ab8c83f82eb14e0e9326b5954fed6902,
title = "Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia",
abstract = "Background: The benefits of allogeneic peripheral blood stem/progenitor cell transplantation (PBSCT) over bone marrow transplantation (BMT), if any, have not been seriously evaluated in a pediatric population. We report here our experience with this procedure and demonstrate rapid engraftment to reduce procedure-related complications and enhanced allogeneic immune reaction to reduce leukemic relapse. Methods: The feasibility of PBSCT was reviewed retrospectively. Four patients (2 AML and 2 ALL, aged 8-18 years) underwent allogeneic PBSCT for relapsed leukemia after primary allogeneic BMT (n = 2), for active hepatosplenic fungal abscess (n = 1) or for refractory relapse with conventional chemotherapy (n = 1). Four healthy donors (aged 10-49 years) received granulocyte colony-stimulating factor (G-CSF) 10 μg/kg/day by subcutaneous injection for 5 days. An individualized cytoreductive regimen was used before transplantation. Results: No significant toxicities were observed in normal donors on G-CSF treatment or rat collection of PBSC. After PBSCT, no significant acute toxicities were observed and the median duration to an absolute granulocyte count of 0.5 × 109/l and a platelet count of 20 × 109/l was 16 and 21 days, respectively. Although none of our patients developed acute graft-versus-host disease (GVHD), two developed chronic GVHD involving the liver and skin. Among those who developed chronic GVHD, one died of recurrent disease and another died of pneumonia 235 days after PBSCT. The two remaining patients have been alive without evidence of disease with follow-ups of 193 and 123 days, respectively. Conclusions: Allogeneic PBSCT can be a safe procedure in a pediatric population with fewer acute complications, although the potential risk of G-CSF treatment in normal donors should be seriously weighed against the existing risks of marrow aspiration under general anesthesia. The risk of chronic GVHD may need to be balanced against a possible graft-versus-leukemia benefit in patients at higher risk of leukemic relapse.",
keywords = "Acute leukemia, Allogeneic peripheral blood stem cell transplantation, Children, Graft-versus-host disease, Graft-versus-leukemia",
author = "Hiroshi Matsubara and Atsushi Makimoto and Jun Takayama and Takeshi Higa and Takeshi Saito and Yoshinobu Kanda and Ryuji Tanosaki and Shin Mineishi and Mutsuro Ohira and Yoichi Takaue",
year = "2001",
language = "English",
volume = "31",
pages = "30--34",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia

AU - Matsubara, Hiroshi

AU - Makimoto, Atsushi

AU - Takayama, Jun

AU - Higa, Takeshi

AU - Saito, Takeshi

AU - Kanda, Yoshinobu

AU - Tanosaki, Ryuji

AU - Mineishi, Shin

AU - Ohira, Mutsuro

AU - Takaue, Yoichi

PY - 2001

Y1 - 2001

N2 - Background: The benefits of allogeneic peripheral blood stem/progenitor cell transplantation (PBSCT) over bone marrow transplantation (BMT), if any, have not been seriously evaluated in a pediatric population. We report here our experience with this procedure and demonstrate rapid engraftment to reduce procedure-related complications and enhanced allogeneic immune reaction to reduce leukemic relapse. Methods: The feasibility of PBSCT was reviewed retrospectively. Four patients (2 AML and 2 ALL, aged 8-18 years) underwent allogeneic PBSCT for relapsed leukemia after primary allogeneic BMT (n = 2), for active hepatosplenic fungal abscess (n = 1) or for refractory relapse with conventional chemotherapy (n = 1). Four healthy donors (aged 10-49 years) received granulocyte colony-stimulating factor (G-CSF) 10 μg/kg/day by subcutaneous injection for 5 days. An individualized cytoreductive regimen was used before transplantation. Results: No significant toxicities were observed in normal donors on G-CSF treatment or rat collection of PBSC. After PBSCT, no significant acute toxicities were observed and the median duration to an absolute granulocyte count of 0.5 × 109/l and a platelet count of 20 × 109/l was 16 and 21 days, respectively. Although none of our patients developed acute graft-versus-host disease (GVHD), two developed chronic GVHD involving the liver and skin. Among those who developed chronic GVHD, one died of recurrent disease and another died of pneumonia 235 days after PBSCT. The two remaining patients have been alive without evidence of disease with follow-ups of 193 and 123 days, respectively. Conclusions: Allogeneic PBSCT can be a safe procedure in a pediatric population with fewer acute complications, although the potential risk of G-CSF treatment in normal donors should be seriously weighed against the existing risks of marrow aspiration under general anesthesia. The risk of chronic GVHD may need to be balanced against a possible graft-versus-leukemia benefit in patients at higher risk of leukemic relapse.

AB - Background: The benefits of allogeneic peripheral blood stem/progenitor cell transplantation (PBSCT) over bone marrow transplantation (BMT), if any, have not been seriously evaluated in a pediatric population. We report here our experience with this procedure and demonstrate rapid engraftment to reduce procedure-related complications and enhanced allogeneic immune reaction to reduce leukemic relapse. Methods: The feasibility of PBSCT was reviewed retrospectively. Four patients (2 AML and 2 ALL, aged 8-18 years) underwent allogeneic PBSCT for relapsed leukemia after primary allogeneic BMT (n = 2), for active hepatosplenic fungal abscess (n = 1) or for refractory relapse with conventional chemotherapy (n = 1). Four healthy donors (aged 10-49 years) received granulocyte colony-stimulating factor (G-CSF) 10 μg/kg/day by subcutaneous injection for 5 days. An individualized cytoreductive regimen was used before transplantation. Results: No significant toxicities were observed in normal donors on G-CSF treatment or rat collection of PBSC. After PBSCT, no significant acute toxicities were observed and the median duration to an absolute granulocyte count of 0.5 × 109/l and a platelet count of 20 × 109/l was 16 and 21 days, respectively. Although none of our patients developed acute graft-versus-host disease (GVHD), two developed chronic GVHD involving the liver and skin. Among those who developed chronic GVHD, one died of recurrent disease and another died of pneumonia 235 days after PBSCT. The two remaining patients have been alive without evidence of disease with follow-ups of 193 and 123 days, respectively. Conclusions: Allogeneic PBSCT can be a safe procedure in a pediatric population with fewer acute complications, although the potential risk of G-CSF treatment in normal donors should be seriously weighed against the existing risks of marrow aspiration under general anesthesia. The risk of chronic GVHD may need to be balanced against a possible graft-versus-leukemia benefit in patients at higher risk of leukemic relapse.

KW - Acute leukemia

KW - Allogeneic peripheral blood stem cell transplantation

KW - Children

KW - Graft-versus-host disease

KW - Graft-versus-leukemia

UR - http://www.scopus.com/inward/record.url?scp=0035076113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035076113&partnerID=8YFLogxK

M3 - Article

VL - 31

SP - 30

EP - 34

JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

SN - 0368-2811

IS - 1

ER -