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Blood, Vol. 94 No. 2 (July 15), 1999:
pp. 455-464
Peripheral Blood Stem Cell Transplantation From Unrelated Donors: A
Comparison With Marrow Transplantation
O. Ringdén,
M. Remberger,
V. Runde,
M. Bornhäuser,
I.W. Blau,
N. Basara,
K. Hölig,
D.W. Beelen,
H. Hägglund,
O. Basu,
G. Ehninger, and
A.A. Fauser
From the Center for Allogeneic Stem Cell Transplantation and
Department of Clinical Immunology, Huddinge Hospital, Huddinge, Sweden;
the Clinic for Bone Marrow Transplantation and Department of Pediatric
Hematology and Oncology, University Clinic Essen, Essen, Germany; the
Department of Hematology, Dresden, Germany; and the Clinic of BMT,
Hematology and Oncology, Idar-Oberstein, Germany.
Peripheral blood stem cell (PBSC) transplants from HLA-A, -B, and
-DR compatible unrelated donors (n = 45) were compared with bone
marrow (BM; BM group, n = 45). Eighteen patients received CD34-selected PBSC (CD34 group). The PBSCs contained more mononuclear cells, CD34+, CD3+, and CD56+
cells compared with marrow (P < .001). Engraftment was
achieved in all 45 patients in the BM group, in 43 of 45 (95%) in the
PBSC group, and in 14 of 18 (78%) in the CD34 group (P < .01). In multivariate analysis, a short time to absolute neutrophil
count (ANC) equal to 0.5 × 109/L was associated with the
PBSC/CD34 groups (P < .001) and granulocyte colony-stimulating factor (G-CSF) treatment (P = .017). A short time to platelets equal to 50 × 109/L was
associated with PBSC (P = .003) and no methotrexate
(P = .015). Grades II-IV acute graft-versus-host disease
(GVHD) was 20% in the BM controls, 30% in the PBSC group, and 18% in
the CD34 group (not significant [NS]). The probability of chronic GVHD was 85% in the BM group, 59% in the PBSC group, and 0% in the
CD34 group (P < .01). One-year transplant-related mortality was 21% and 27% and survival was 53% and 54% in the BM and PBSC groups, respectively (NS). The 2-year relapse-free survival was 41%
and 46% in the two groups, respectively.
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