Retrospective comparison of bone marrow and granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for allogeneic stem cell transplantation using HLA identical sibling donors in myelodysplastic syndromes

Philippe Guardiola, Volker Runde, Andrea Bacigalupo, Tapani Ruutu, Franco Locatelli, Marc A. Boogaerts, Antonio Pagliuca, Jan J. Cornelissen, Harry C. Schouten, Enric Carreras, Jürgen Finke, Anja Van Biezen, Ronald Brand, Dietger Niederwieser, Eliane Gluckman, Theo M. De Witte

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Abstract

In this multicenter retrospective study, the outcomes of 234 patients with myelodysplastic syndrome (MDS) who underwent transplantation between 1995 and 1999 from HLA-identical siblings were analyzed according to the hematopoietic stem cell source used, that is, bone marrow (BM, n = 132) or granulocyte colonystimulating factor-mobilized peripheral blood progenitor cells (PBPCs, n = 102). There were 69 cases of refractory anemia (RA), 86 RA with excess blasts (RAEB), 75 RAEB in transformation (RAEB-t), and 4 unclassified MDS at diagnosis. The International Prognostic Scoring System was intermediate-2 or high in 104 of the 158 available scores. Multivariate analyses focused on transplantation-related mortality (TRM), 2-year treatment failure incidence, and survival. Use of PBPCs reduced the median duration of neutropenia and thrombocytopenia by 4 and 12 days, respectively. The incidence of acute GVHD was similar whatever the graft type used. Chronic GVHD was more likely to have occurred with PBPCs (odds ratio [OR], 1.62; 95% confidence interval [C], 0.87-3.02). Two-year TRM was significantly reduced with PBPCs (relative risk [RR], 0.33; 95% C, 0.15-0.73; P <.007), except for patients who had either RA or high-risk cytogenetics. The 2-year treatment failure incidence was significantly decreased with PBPCs, from 38% to 13% (RR, 0.22; 95% C, 0.10-0.48; P <.001). Estimate of the 2-year event-free survival was 50% with PBPCs versus 39% with BM. In multivariate analysis, the outcome was significantly improved with PBPCs (RR, 0.27; 95% C, 0.13-0.52; P <.001), except for patients with either RA or highrisk cytogenetics. In conclusion, PBPCs might be preferred for allogeneic transplantation in MDS patients at high risk for relapse on the basis of morphologic criteria because the use of this hematopoietic stem cell was associated with lower treatment failure incidence and improved survival.

Original languageEnglish
Pages (from-to)4370-4378
Number of pages9
JournalBlood
Volume99
Issue number12
DOIs
Publication statusPublished - Jun 15 2002

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Myelodysplastic Syndromes
Stem Cell Transplantation
Granulocyte Colony-Stimulating Factor
Stem cells
Siblings
Blood Cells
Refractory Anemia
Bone
Blood
Stem Cells
Bone Marrow
Refractory materials
Tissue Donors
Treatment Failure
Transplantation
Incidence
Hematopoietic Stem Cells
Cytogenetics
Multivariate Analysis
Refractory Anemia with Excess of Blasts

ASJC Scopus subject areas

  • Hematology

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Retrospective comparison of bone marrow and granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for allogeneic stem cell transplantation using HLA identical sibling donors in myelodysplastic syndromes. / Guardiola, Philippe; Runde, Volker; Bacigalupo, Andrea; Ruutu, Tapani; Locatelli, Franco; Boogaerts, Marc A.; Pagliuca, Antonio; Cornelissen, Jan J.; Schouten, Harry C.; Carreras, Enric; Finke, Jürgen; Van Biezen, Anja; Brand, Ronald; Niederwieser, Dietger; Gluckman, Eliane; De Witte, Theo M.

In: Blood, Vol. 99, No. 12, 15.06.2002, p. 4370-4378.

Research output: Contribution to journalArticle

Guardiola, P, Runde, V, Bacigalupo, A, Ruutu, T, Locatelli, F, Boogaerts, MA, Pagliuca, A, Cornelissen, JJ, Schouten, HC, Carreras, E, Finke, J, Van Biezen, A, Brand, R, Niederwieser, D, Gluckman, E & De Witte, TM 2002, 'Retrospective comparison of bone marrow and granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for allogeneic stem cell transplantation using HLA identical sibling donors in myelodysplastic syndromes', Blood, vol. 99, no. 12, pp. 4370-4378. https://doi.org/10.1182/blood.V99.12.4370
Guardiola, Philippe ; Runde, Volker ; Bacigalupo, Andrea ; Ruutu, Tapani ; Locatelli, Franco ; Boogaerts, Marc A. ; Pagliuca, Antonio ; Cornelissen, Jan J. ; Schouten, Harry C. ; Carreras, Enric ; Finke, Jürgen ; Van Biezen, Anja ; Brand, Ronald ; Niederwieser, Dietger ; Gluckman, Eliane ; De Witte, Theo M. / Retrospective comparison of bone marrow and granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for allogeneic stem cell transplantation using HLA identical sibling donors in myelodysplastic syndromes. In: Blood. 2002 ; Vol. 99, No. 12. pp. 4370-4378.
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abstract = "In this multicenter retrospective study, the outcomes of 234 patients with myelodysplastic syndrome (MDS) who underwent transplantation between 1995 and 1999 from HLA-identical siblings were analyzed according to the hematopoietic stem cell source used, that is, bone marrow (BM, n = 132) or granulocyte colonystimulating factor-mobilized peripheral blood progenitor cells (PBPCs, n = 102). There were 69 cases of refractory anemia (RA), 86 RA with excess blasts (RAEB), 75 RAEB in transformation (RAEB-t), and 4 unclassified MDS at diagnosis. The International Prognostic Scoring System was intermediate-2 or high in 104 of the 158 available scores. Multivariate analyses focused on transplantation-related mortality (TRM), 2-year treatment failure incidence, and survival. Use of PBPCs reduced the median duration of neutropenia and thrombocytopenia by 4 and 12 days, respectively. The incidence of acute GVHD was similar whatever the graft type used. Chronic GVHD was more likely to have occurred with PBPCs (odds ratio [OR], 1.62; 95{\%} confidence interval [C], 0.87-3.02). Two-year TRM was significantly reduced with PBPCs (relative risk [RR], 0.33; 95{\%} C, 0.15-0.73; P <.007), except for patients who had either RA or high-risk cytogenetics. The 2-year treatment failure incidence was significantly decreased with PBPCs, from 38{\%} to 13{\%} (RR, 0.22; 95{\%} C, 0.10-0.48; P <.001). Estimate of the 2-year event-free survival was 50{\%} with PBPCs versus 39{\%} with BM. In multivariate analysis, the outcome was significantly improved with PBPCs (RR, 0.27; 95{\%} C, 0.13-0.52; P <.001), except for patients with either RA or highrisk cytogenetics. In conclusion, PBPCs might be preferred for allogeneic transplantation in MDS patients at high risk for relapse on the basis of morphologic criteria because the use of this hematopoietic stem cell was associated with lower treatment failure incidence and improved survival.",
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T1 - Retrospective comparison of bone marrow and granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for allogeneic stem cell transplantation using HLA identical sibling donors in myelodysplastic syndromes

AU - Guardiola, Philippe

AU - Runde, Volker

AU - Bacigalupo, Andrea

AU - Ruutu, Tapani

AU - Locatelli, Franco

AU - Boogaerts, Marc A.

AU - Pagliuca, Antonio

AU - Cornelissen, Jan J.

AU - Schouten, Harry C.

AU - Carreras, Enric

AU - Finke, Jürgen

AU - Van Biezen, Anja

AU - Brand, Ronald

AU - Niederwieser, Dietger

AU - Gluckman, Eliane

AU - De Witte, Theo M.

PY - 2002/6/15

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N2 - In this multicenter retrospective study, the outcomes of 234 patients with myelodysplastic syndrome (MDS) who underwent transplantation between 1995 and 1999 from HLA-identical siblings were analyzed according to the hematopoietic stem cell source used, that is, bone marrow (BM, n = 132) or granulocyte colonystimulating factor-mobilized peripheral blood progenitor cells (PBPCs, n = 102). There were 69 cases of refractory anemia (RA), 86 RA with excess blasts (RAEB), 75 RAEB in transformation (RAEB-t), and 4 unclassified MDS at diagnosis. The International Prognostic Scoring System was intermediate-2 or high in 104 of the 158 available scores. Multivariate analyses focused on transplantation-related mortality (TRM), 2-year treatment failure incidence, and survival. Use of PBPCs reduced the median duration of neutropenia and thrombocytopenia by 4 and 12 days, respectively. The incidence of acute GVHD was similar whatever the graft type used. Chronic GVHD was more likely to have occurred with PBPCs (odds ratio [OR], 1.62; 95% confidence interval [C], 0.87-3.02). Two-year TRM was significantly reduced with PBPCs (relative risk [RR], 0.33; 95% C, 0.15-0.73; P <.007), except for patients who had either RA or high-risk cytogenetics. The 2-year treatment failure incidence was significantly decreased with PBPCs, from 38% to 13% (RR, 0.22; 95% C, 0.10-0.48; P <.001). Estimate of the 2-year event-free survival was 50% with PBPCs versus 39% with BM. In multivariate analysis, the outcome was significantly improved with PBPCs (RR, 0.27; 95% C, 0.13-0.52; P <.001), except for patients with either RA or highrisk cytogenetics. In conclusion, PBPCs might be preferred for allogeneic transplantation in MDS patients at high risk for relapse on the basis of morphologic criteria because the use of this hematopoietic stem cell was associated with lower treatment failure incidence and improved survival.

AB - In this multicenter retrospective study, the outcomes of 234 patients with myelodysplastic syndrome (MDS) who underwent transplantation between 1995 and 1999 from HLA-identical siblings were analyzed according to the hematopoietic stem cell source used, that is, bone marrow (BM, n = 132) or granulocyte colonystimulating factor-mobilized peripheral blood progenitor cells (PBPCs, n = 102). There were 69 cases of refractory anemia (RA), 86 RA with excess blasts (RAEB), 75 RAEB in transformation (RAEB-t), and 4 unclassified MDS at diagnosis. The International Prognostic Scoring System was intermediate-2 or high in 104 of the 158 available scores. Multivariate analyses focused on transplantation-related mortality (TRM), 2-year treatment failure incidence, and survival. Use of PBPCs reduced the median duration of neutropenia and thrombocytopenia by 4 and 12 days, respectively. The incidence of acute GVHD was similar whatever the graft type used. Chronic GVHD was more likely to have occurred with PBPCs (odds ratio [OR], 1.62; 95% confidence interval [C], 0.87-3.02). Two-year TRM was significantly reduced with PBPCs (relative risk [RR], 0.33; 95% C, 0.15-0.73; P <.007), except for patients who had either RA or high-risk cytogenetics. The 2-year treatment failure incidence was significantly decreased with PBPCs, from 38% to 13% (RR, 0.22; 95% C, 0.10-0.48; P <.001). Estimate of the 2-year event-free survival was 50% with PBPCs versus 39% with BM. In multivariate analysis, the outcome was significantly improved with PBPCs (RR, 0.27; 95% C, 0.13-0.52; P <.001), except for patients with either RA or highrisk cytogenetics. In conclusion, PBPCs might be preferred for allogeneic transplantation in MDS patients at high risk for relapse on the basis of morphologic criteria because the use of this hematopoietic stem cell was associated with lower treatment failure incidence and improved survival.

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