Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia
•There was higher overall mortality after peripheral blood transplant than with bone marrow transplant.•Lower relapse occurred after peripheral blood transplant than with bone marrow transplant.•No survival advantage was found despite lower relapse after peripheral blood transplant. Graft-versus-hos...
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| Veröffentlicht in: | Biology of blood and marrow transplantation 2018-12, Vol.24 (12), p.2487-2492 |
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| container_title | Biology of blood and marrow transplantation |
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| creator | Keesler, Daniel A. St. Martin, Andrew Bonfim, Carmem Seber, Adriana Zhang, Mei-Jie Eapen, Mary |
| description | •There was higher overall mortality after peripheral blood transplant than with bone marrow transplant.•Lower relapse occurred after peripheral blood transplant than with bone marrow transplant.•No survival advantage was found despite lower relapse after peripheral blood transplant.
Graft-versus-host disease (GVHD) rates are higher after unrelated donor transplantation; thus, we examined whether there would be differences in transplant outcomes by graft type in children and adolescents with acute leukemia. The primary endpoint was overall survival. We studied 872 patients |
| doi_str_mv | 10.1016/j.bbmt.2018.08.010 |
| format | Article |
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Graft-versus-host disease (GVHD) rates are higher after unrelated donor transplantation; thus, we examined whether there would be differences in transplant outcomes by graft type in children and adolescents with acute leukemia. The primary endpoint was overall survival. We studied 872 patients <18 years old who were transplanted with bone marrow (n = 650) or peripheral blood (n = 222) from unrelated donors. The characteristics of the 2 groups were comparable, except recipients of bone marrow were younger than recipients of peripheral blood (median age, 10 versus 12 years). Grades 2 to 4 (hazard ratio [HR], 1.48; P < .001) and grades 3 and 4 acute (HR, 1.69; P < .001) and chronic GVHD (HR, 1.92; P < .001) were higher with transplantation of peripheral blood than with bone marrow. Although relapse risks were lower after peripheral blood transplants (HR, 0.76; P = .05), transplant-related mortality (HR, 1.91; P = .003) and overall mortality (HR, 1.34; P = .032) were higher than with bone marrow transplants. The 8-year probability of overall survival after transplantation of bone marrow was 47% compared with 42% after peripheral blood. The 8-year probability of leukemia-free survival was 40% after transplantation of bone marrow and peripheral blood. Lower relapse after transplantation of peripheral blood negated the survival advantage after transplantation of bone marrow. The observed higher acute and chronic GVHD seen with peripheral blood suggest cautious use of this graft in children and adolescents with acute leukemia.</description><identifier>ISSN: 1083-8791</identifier><identifier>EISSN: 1523-6536</identifier><identifier>DOI: 10.1016/j.bbmt.2018.08.010</identifier><identifier>PMID: 30142417</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute lymphoblastic leukemia (ALL) ; Acute myeloid leukemia (AML) ; Children ; Graft-versus-host disease (GVHD) ; Peripheral blood</subject><ispartof>Biology of blood and marrow transplantation, 2018-12, Vol.24 (12), p.2487-2492</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier Inc.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-3312c0af74433ec150f0123a0fcd3c12f79ac265439e970403805ac3f9908f533</citedby><cites>FETCH-LOGICAL-c455t-3312c0af74433ec150f0123a0fcd3c12f79ac265439e970403805ac3f9908f533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1083879118304750$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30142417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keesler, Daniel A.</creatorcontrib><creatorcontrib>St. Martin, Andrew</creatorcontrib><creatorcontrib>Bonfim, Carmem</creatorcontrib><creatorcontrib>Seber, Adriana</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Eapen, Mary</creatorcontrib><title>Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia</title><title>Biology of blood and marrow transplantation</title><addtitle>Biol Blood Marrow Transplant</addtitle><description>•There was higher overall mortality after peripheral blood transplant than with bone marrow transplant.•Lower relapse occurred after peripheral blood transplant than with bone marrow transplant.•No survival advantage was found despite lower relapse after peripheral blood transplant.
Graft-versus-host disease (GVHD) rates are higher after unrelated donor transplantation; thus, we examined whether there would be differences in transplant outcomes by graft type in children and adolescents with acute leukemia. The primary endpoint was overall survival. We studied 872 patients <18 years old who were transplanted with bone marrow (n = 650) or peripheral blood (n = 222) from unrelated donors. The characteristics of the 2 groups were comparable, except recipients of bone marrow were younger than recipients of peripheral blood (median age, 10 versus 12 years). Grades 2 to 4 (hazard ratio [HR], 1.48; P < .001) and grades 3 and 4 acute (HR, 1.69; P < .001) and chronic GVHD (HR, 1.92; P < .001) were higher with transplantation of peripheral blood than with bone marrow. Although relapse risks were lower after peripheral blood transplants (HR, 0.76; P = .05), transplant-related mortality (HR, 1.91; P = .003) and overall mortality (HR, 1.34; P = .032) were higher than with bone marrow transplants. The 8-year probability of overall survival after transplantation of bone marrow was 47% compared with 42% after peripheral blood. The 8-year probability of leukemia-free survival was 40% after transplantation of bone marrow and peripheral blood. Lower relapse after transplantation of peripheral blood negated the survival advantage after transplantation of bone marrow. The observed higher acute and chronic GVHD seen with peripheral blood suggest cautious use of this graft in children and adolescents with acute leukemia.</description><subject>Acute lymphoblastic leukemia (ALL)</subject><subject>Acute myeloid leukemia (AML)</subject><subject>Children</subject><subject>Graft-versus-host disease (GVHD)</subject><subject>Peripheral blood</subject><issn>1083-8791</issn><issn>1523-6536</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9UU2LFDEQDaK46-of8CA5eumx8tFfIMLs-AkjenDPIZNUnIzdyZh0z-K_N82si16EgiqoV69e1SPkOYMVA9a8Oqx2u3FacWDdCkoweEAuWc1F1dSieVhq6ETVtT27IE9yPgBAK7v-MbkQwCSXrL0kh-sYkH7WKcVbesKU50y_YvLHPSY90OshRktdiiO9CQkHPaGlb2OIKVMXE93s_WATBqqDpWsbB8wGw5TprZ_2dG3mCekW5x84ev2UPHJ6yPjsLl-Rm_fvvm0-VtsvHz5t1tvKyLqeKiEYN6BdK6UQaFgNDhgXGpyxwjDu2l4b3tRS9Ni3IEF0UGsjXN9D52ohrsibM-9x3o1oFz3lFHVMftTpl4raq387we_V93hSDe8aLptC8PKOIMWfM-ZJjb6cNQw6YJyz4tALCbxpFyg_Q02KOSd092sYqMUkdVCLSWoxSUEJBmXoxd8C70f-uFIAr88ALG86eUwqG4_BoPUJzaRs9P_j_w04ZaQh</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Keesler, Daniel A.</creator><creator>St. Martin, Andrew</creator><creator>Bonfim, Carmem</creator><creator>Seber, Adriana</creator><creator>Zhang, Mei-Jie</creator><creator>Eapen, Mary</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181201</creationdate><title>Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia</title><author>Keesler, Daniel A. ; St. Martin, Andrew ; Bonfim, Carmem ; Seber, Adriana ; Zhang, Mei-Jie ; Eapen, Mary</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-3312c0af74433ec150f0123a0fcd3c12f79ac265439e970403805ac3f9908f533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute lymphoblastic leukemia (ALL)</topic><topic>Acute myeloid leukemia (AML)</topic><topic>Children</topic><topic>Graft-versus-host disease (GVHD)</topic><topic>Peripheral blood</topic><toplevel>online_resources</toplevel><creatorcontrib>Keesler, Daniel A.</creatorcontrib><creatorcontrib>St. Martin, Andrew</creatorcontrib><creatorcontrib>Bonfim, Carmem</creatorcontrib><creatorcontrib>Seber, Adriana</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Eapen, Mary</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Biology of blood and marrow transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keesler, Daniel A.</au><au>St. Martin, Andrew</au><au>Bonfim, Carmem</au><au>Seber, Adriana</au><au>Zhang, Mei-Jie</au><au>Eapen, Mary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia</atitle><jtitle>Biology of blood and marrow transplantation</jtitle><addtitle>Biol Blood Marrow Transplant</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>24</volume><issue>12</issue><spage>2487</spage><epage>2492</epage><pages>2487-2492</pages><issn>1083-8791</issn><eissn>1523-6536</eissn><abstract>•There was higher overall mortality after peripheral blood transplant than with bone marrow transplant.•Lower relapse occurred after peripheral blood transplant than with bone marrow transplant.•No survival advantage was found despite lower relapse after peripheral blood transplant.
Graft-versus-host disease (GVHD) rates are higher after unrelated donor transplantation; thus, we examined whether there would be differences in transplant outcomes by graft type in children and adolescents with acute leukemia. The primary endpoint was overall survival. We studied 872 patients <18 years old who were transplanted with bone marrow (n = 650) or peripheral blood (n = 222) from unrelated donors. The characteristics of the 2 groups were comparable, except recipients of bone marrow were younger than recipients of peripheral blood (median age, 10 versus 12 years). Grades 2 to 4 (hazard ratio [HR], 1.48; P < .001) and grades 3 and 4 acute (HR, 1.69; P < .001) and chronic GVHD (HR, 1.92; P < .001) were higher with transplantation of peripheral blood than with bone marrow. Although relapse risks were lower after peripheral blood transplants (HR, 0.76; P = .05), transplant-related mortality (HR, 1.91; P = .003) and overall mortality (HR, 1.34; P = .032) were higher than with bone marrow transplants. The 8-year probability of overall survival after transplantation of bone marrow was 47% compared with 42% after peripheral blood. The 8-year probability of leukemia-free survival was 40% after transplantation of bone marrow and peripheral blood. Lower relapse after transplantation of peripheral blood negated the survival advantage after transplantation of bone marrow. The observed higher acute and chronic GVHD seen with peripheral blood suggest cautious use of this graft in children and adolescents with acute leukemia.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30142417</pmid><doi>10.1016/j.bbmt.2018.08.010</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Biology of blood and marrow transplantation, 2018-12, Vol.24 (12), p.2487-2492 |
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| language | eng |
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| source | Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Acute lymphoblastic leukemia (ALL) Acute myeloid leukemia (AML) Children Graft-versus-host disease (GVHD) Peripheral blood |
| title | Bone Marrow versus Peripheral Blood from Unrelated Donors for Children and Adolescents with Acute Leukemia |
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