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Blood, 15 August 2007, Vol. 110, No. 4, pp. 1397-1400.
Prepublished online as a Blood First Edition Paper on May 2, 2007; DOI 10.1182/blood-2007-03-081596.
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Submitted March 22, 2007
Accepted April 30, 2007
Worse outcome and more chronic GVHD with peripheral blood progenitor cells than bone marrow in HLA-matched sibling donor transplants for young patients with severe acquired aplastic anemia: A report from the European Group for Blood and Marrow Transplantation and the Center for International Blood and Marrow Transplant Research
Hubert Schrezenmeier, Jakob R. Passweg, Judith C.W. Marsh, Andrea Bacigalupo, Christopher N. Bredeson, Eduardo Bullorsky, Bruce M. Camitta, Richard E. Champlin, Robert Peter Gale, Monika Fuhrer, John P. Klein, Anna Locasciulli, Rosi Oneto, Antonius V.M.B. Scahttenberg, Gerard Socie, and Mary Eapen*
Institute of Clinical Transfusion Medicine & Immunogenetics, University of Ulm, Ulm, Germany
Hopitaux Universitaires, Geneva, Switzerland
St. George's Hospital Medical School, London, United Kingdom
Ospedale S. Martino, Genova, Italy
Medical College of Wisconsin, Milwaukee, WI, United States
Hosptial Britanico, Buenos Aires, Argentina
M.D. Anderson Cancer Center, Houston, TX, United States
Center for Advanced Studies in Leukemia, Los Angeles, CA, United States
Universitat Munchen, Munich, Germany
Statistical Center, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States
Ospedale S. Camillo-Forlanini, Rome, Italy
University Medical Center, Nijmegen, Netherlands
St. Louis Hospital-1, Paris, France
* Corresponding author; email: meapen{at}mcw.edu.
We analyzed outcome of 692 patients with severe aplastic anemia (SAA) receiving transplants from HLA-matched siblings. One hundred and thirty four grafts were peripheral blood progenitor cell (PBPC) and 558 bone marrow (BM) grafts. Rates of hematopoietic recovery and grades 2-4 acute graft-versus-host disease (GVHD) were similar after PBSC and BM transplants regardless of age at transplantation. In patients aged >20 years, chronic GVHD and overall mortality rates were similar after PBPC and BM transplants. In patients' aged  20 years, rates of chronic GVHD (RR 2.82, p=0.002) and overall mortality (RR 2.04, p=0.024) were higher after transplantation of PBPC than after BM. In younger patients, the 5-year probabilities of overall survival were 73% and 85% after PBPC and BM transplants, respectively. Corresponding probabilities for older patients were 52% and 64%. These data indicate that BM grafts are preferred to PBPC in young patients undergoing HLA-matched sibling donor transplantation for SAA.
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