The inferiority of G-PB to rhG-CSF-mobilized blood and marrow grafts as a stem cell source in patients with high-risk acute leukemia who underwent unmanipulated HLA-mismatched/haploidentical transplantation: a comparative analysis

L-P Xu, K-Y Liu, D-H Liu, H Chen, W Han, Y-H Chen, Y Wang, X-J Huang
Bone Marrow Transplantation 2010, 45 (6): 985-92
The purpose of this study was to investigate the efficacy and feasibility of unmanipulated haploidentical PBSCT for the treatment of acute leukemia (AL). This study compares the clinical outcomes of high-risk AL patients who received PBSCs harvested from family members sharing at least one common haplotype to outcomes of high-risk AL patients who received a mixture of G-CSF-primed BM (G-BM) and peripheral blood (G-PB) harvests. The results show that PBSCT achieved inferior cumulative myeloid engraftment at 30 days after transplant (89.9 + or - 10.1% vs 100%; P=0.04), with lower cumulative incidence of grade II-IV acute GVHD (aGVHD) (37.1 + or - 16.5% vs 63.2+/-6%; P=0.058) compared with G-BM/G-PB transplant. However, both transplant protocols had similar rates of 2-year relapse (29.6 + or - 17.1% vs 34.0 + or - 5.7%; P=0.954), and PBSCT produced a higher incidence of 2-year non-leukemic mortality (62.5 + or - 14.8% vs 35.1 + or - 5.1%; P=0.014), as well as lower rates of overall (26.8 + or - 12.3% vs 43.2 + or - 5.0%; P=0.052) and disease-free survival (26.8 + or - 12.3% vs 42.4 + or - 5.0%; P=0.071) compared with G-BM/G-PB transplant. These results suggest that haploidentical HSCT is an option for patients with AL who urgently need a graft and do not have matched sibling donors. PBSCT is potentially inferior to G-BM/G-PB transplant, and improvements should be made before PBSCT becomes a routine in unmanipulated mismatched/haploidentical transplant settings.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"