Marrow, Peripheral Blood Yield Comparable 5-year Survival in Reduced-Intensity HCT

This study examining the outcomes of peripheral blood stem cell (PB) and bone marrow (BM) transplants using reduced-intensity conditioning found no significant differences in outcomes based on graft source. This retrospective study analyzed outcomes of PB (n=887) and BM (n=219) unrelated donor transplants in adults with acute myelogenous leukemia (AML), myelodysplastic syndromes, or non-Hodgkin lymphomas reported by U.S. transplant centers to CIBMTR (Center for International Blood and Marrow Transplant Research) between 2000 and 2008. Conditioning regimens consisted of an alkylating agent and fludarabine, and GVHD prophylaxis involved a calcineurin inhibitor (CNI) with either methotrexate (MTX) or mycophenolate mofetil (MMF). Adjusted 5-year survival in the PB and BM groups were comparable: 34% versus 38%, respectively, using CNI-MTX; and 27% versus 20%, respectively, using CNI-MMF. Overall survival and the incidence of grade 2-4 cGVHD are consistent with myeloablative conditioning regimens in previously published studies. The authors noted that “the effect of GVHD prophylaxis on survival merits further evaluation.”

Eapen M, et al. J Clin Oncol

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