Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomized trial
Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomized trial
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DOI：
10.1182/blood-2002-01-0011
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发表时间：
2002-07-15
期刊：
影响因子：
20.3
通讯作者：
Martin, PJ
中科院分区：
文献类型：
--
作者：
Flowers, MED;Parker, PM;Martin, PJ
在之前的一项多中心III期试验中，比较外周血干细胞移植（PBSCT）和hla匹配相关供者骨髓移植（BMT），我们发现两组患者临床广泛慢性移植物抗宿主病（GVHD）的累积发病率无统计学差异。我们对结果进行了更详细的分析，以确定PBSCT后慢性GVHD的临床特征是否与BMT后发生的临床特征不同。在移植后100天存活且无恶性肿瘤的63例PBSCs受者中有39例和63例BM受者中有32例出现临床广泛的慢性GVHD。临床广泛性慢性GVHD的发病时间和类型以及与严重发病率相关的并发症发生频率均无显著差异。皮肤和女性生殖道受累在PBSC受者中比BM受者更常见。两组3年慢性GVHD的累积发病率相似，但PBSCT后控制慢性GVHD所需的连续治疗次数高于BIVIT后（P = 0.03）， PBSCT后糖皮质激素治疗时间长于BIVIT后（P = 0.03）。这些结果表明，与BMT后的慢性GVHD相比，PBSCT后的慢性GVHD可能更持久，对当前治疗的反应更弱。与BMT相比，评估PBSCT的总体益处需要对慢性GVHD相关发病率进行持续的长期随访。(血。100:415 2002;419)。(C) 2002年由美国血液病学会出版。
In a previous multicenter phase III trial comparing peripheral blood stem cell transplantation (PBSCT) to bone marrow transplantation (BMT) from HLA-matched related donors, we found no statistically significant difference in the cumulative incidence of clinical extensive chronic graft-versus-host disease (GVHD) in the 2 groups. We have analyzed the results in more detail to determine whether the clinical characteristics of chronic GVHD after PBSCT might be distinct from those that occur after BMT. Clinical extensive chronic GVHD developed in 39 of 63 recipients of PBSCs and in 32 of 63 BM recipients who were alive and free of malignancy at day 100 after the transplantation. No significant differences were found in the time and type of onset of clinical extensive chronic GVHD or in the frequency of complications associated with severe morbidity. Involvement of skin and female genital tract was more frequent in PBSC recipients than in BM recipients. The cumulative incidence of chronic GVHD at 3 years was similar in the 2 groups, but the number of successive treatments needed to control chronic GVHD was higher after PBSCT than after BIVIT (P =.03), and the duration of glucocorticoid treatment was longer after PBSCT compared to BIVIT (P =.03). These results suggest that chronic GVHD after PBSCT may be more protracted and less responsive to current treatment than chronic GVHD after BMT. Assessment of the overall benefits of PBSCT compared to BMT will require continued long-term follow up of morbidity associated with chronic GVHD. (Blood. 2002;100:415-419). (C) 2002 by The American Society of Hematology.