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Blood, 15 January 2005, Vol. 105, No. 2, pp. 548-551. Prepublished online as a Blood First Edition Paper on September 14, 2004; DOI 10.1182/blood-2004-03-1000.
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Increased risk of extensive chronic graft-versus-host disease after allogeneic peripheral blood stem cell transplantation using unrelated donorsFrom the Centre for Allogeneic Stem Cell Transplantation and Department of Clinical Immunology, Karolinska University Hospital, Stockholm, Sweden; the Department of Bone Marrow Transplantation, University Hospital Essen, Germany; the Clinic of BMT, Haematology and Oncology, Idar-Oberstein, Germany; and the Department of Paediatric Haematology, Oncology and Endocrinology, University Hospital Essen, Germany.
The long-term follow-up of a study including 214 patients receiving either peripheral blood stem cells (PBSCs) or bone marrow (BM) from an HLA-A, -B, and -DRcompatible unrelated donor is presented. Median follow-up was 4.4 (2.3-7.3) and 5.0 (0.7-8.4) years in the 2 groups, respectively. Cumulative incidence of overall chronic graft-versus-host disease (GVHD) was similar in the 2 groups (78% vs 71%), while extensive chronic GVHD was significantly more common in the PBSC group compared with the BM group (39% vs 24%, P = .03). The 5-year transplant-related mortality (TRM) was 37% in the PBSC group and 35% in the BM controls (P = .7), and overall survival was 42% in both groups. The relapse incidences were 26% and 27% in the 2 groups, respectively, resulting in a disease-free survival of 41% in both groups. In conclusion, PBSCs from HLA-compatible unrelated donors results in similar outcome compared to BM but implies an increased risk for extensive chronic GVHD.
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