PMID- 15858704
OWN - NLM
STAT- MEDLINE
DCOM- 20051130
LR  - 20191210
IS  - 0300-8630 (Print)
IS  - 0300-8630 (Linking)
VI  - 217
IP  - 3
DP  - 2005 May-Jun
TI  - Similar survival following HLA-identical sibling transplantation for standard 
      indication in children with haematologic malignancies: a single center comparison 
      of mobilized peripheral blood stem cell with bone marrow transplantation.
PG  - 135-41
AB  - BACKGROUND: Peripheral blood stem cell (PBSC) grafts are increasingly used for 
      autologous and allogeneic haematopoietic stem cell transplantation (alloHSCT) 
      with the aim to hasten neutrophil and platelet engraftment and thereby to reduce 
      transplant-related complications due to infections, bleeding and graft failure. 
      Based on the paucity of data on PBSC transplantation in children we performed a 
      retrospective single-center analysis comparing the outcome of children receiving 
      mobilized PBSC from human leukocyte antigen (HLA)-identical sibling donors to 
      bone marrow (BM) transplant recipients. PATIENTS AND METHODS: Between 1996 and 
      2004, 16 children with haematologic malignancies and standard indication for 
      alloHSCT underwent PBSC transplantation from HLA-identical sibling donors. The 
      outcome of these children was compared to a historic control group of 19 bone 
      marrow (BM) transplant recipients. Time to neutrophil engraftment, incidence of 
      acute and chronic graft-versus-host disease (GvHD), relapse rate, 
      transplant-related mortality, event-free and overall survival were analyzed. 
      RESULTS: Neutrophil engraftment was achieved significantly faster after PBSC 
      compared to BM transplantation with a median time to neutrophil engraftment of 11 
      (range: 8-21) and 19 (16-44) days for the PBSC and BM cohort, respectively (p < 
      0.001). Two of 19 (11 %) BM recipients did not achieve primary neutrophil 
      engraftment and both patients died due to infectious complications. The rate of 
      clinically significant acute GvHD > or = grade II was higher in the PBSC compared 
      to the BM group (75 vs. 39 %; p = 0.045). Incidences of chronic GvHD (PBSC vs. 
      BM: 60 vs. 44 %), death of disease (13 vs. 21 %) and death of complication (13 
      vs. 16 %) were comparable between both groups (p = ns). With a median follow up 
      of 4.7 years (PBSC) and 10.2 years (BM) overall survival (PBSC vs. BM: 68.6 +/- 
      13.5 vs. 63.2 +/- 11.1 %; p = 0.65) and event-free survival (67.0 +/- 12.1 vs. 
      63.2 +/- 11.1 %; p = 0.80) is without demonstrable difference in both groups. 
      CONCLUSIONS: Transplantation of PBSC compared to BM is associated with faster 
      neutrophil engraftment and a higher rate of > or = grade II acute GvHD. As 
      overall survival and event-free survival is similar when using PBSC and BM, PBSC 
      is an alternative stem cell source for HLA-identical sibling transplantation. 
      Further prospective analyses with higher number of patients stratified according 
      to well established risk factors are required to define the precise role of both 
      stem cell sources for children with haematologic malignancies.
FAU - Meisel, R
AU  - Meisel R
AD  - Klinik fur Kinder-Onkologie, -Hamatologie und -Immunologie, Zentrum fur Kinder- 
      und Jugendmedizin, Universitatsklinikum Dusseldorf. meisel@med.uni-duesseldorf.de
FAU - Enczmann, J
AU  - Enczmann J
FAU - Balzer, S
AU  - Balzer S
FAU - Bernbeck, B
AU  - Bernbeck B
FAU - Kramm, C
AU  - Kramm C
FAU - Schonberger, S
AU  - Schonberger S
FAU - Sinha, K
AU  - Sinha K
FAU - Troger, A
AU  - Troger A
FAU - Wernet, P
AU  - Wernet P
FAU - Gobel, U
AU  - Gobel U
FAU - Laws, H J
AU  - Laws HJ
FAU - Dilloo, D
AU  - Dilloo D
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Klin Padiatr
JT  - Klinische Padiatrie
JID - 0326144
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Bone Marrow Transplantation/mortality
MH  - Child
MH  - Child, Preschool
MH  - Data Interpretation, Statistical
MH  - Female
MH  - Graft vs Host Disease/epidemiology
MH  - Hematologic Neoplasms/*therapy
MH  - *Hematopoietic Stem Cell Transplantation/mortality
MH  - Histocompatibility Testing
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Male
MH  - Patient Selection
MH  - *Peripheral Blood Stem Cell Transplantation/mortality
MH  - Retrospective Studies
MH  - Siblings
MH  - Survival Analysis
MH  - Time Factors
MH  - Tissue Donors
EDAT- 2005/04/29 09:00
MHDA- 2005/12/13 09:00
CRDT- 2005/04/29 09:00
PHST- 2005/04/29 09:00 [pubmed]
PHST- 2005/12/13 09:00 [medline]
PHST- 2005/04/29 09:00 [entrez]
AID - 10.1055/s-2005-836509 [doi]
PST - ppublish
SO  - Klin Padiatr. 2005 May-Jun;217(3):135-41. doi: 10.1055/s-2005-836509.