Peripheral blood stem cell transplantation from unrelated donors:: A comparison with marrow transplantation
Peripheral blood stem cell transplantation from unrelated donors:: A comparison with marrow transplantation
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DOI：
10.1182/blood.v94.2.455.414k08_455_464
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发表时间：
1999-07-15
期刊：
影响因子：
20.3
通讯作者：
Fauser, AA
中科院分区：
文献类型：
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作者：
Ringdén, O;Remberger, M;Fauser, AA
将来自HLA-A、-B和-DR相容的无关供体（n = 45）的外周血干细胞（PBSC）移植物与骨髓（BM; BM组，n = 45）进行比较。18例患者接受CD 34选择的PBSC（CD 34组）。与骨髓相比，PBSC含有更多的单个核细胞、CD 34（+）、CD 3（+）和CD 56（+）细胞（P <0.001）。BM组所有45例患者、PBSC组45例中的43例（95%）和CD 34组18例中的14例（78%）均实现了植入（P <0.01）。在多变量分析中，短时间内达到绝对中性粒细胞计数（ANC）等于0.5 × 109/L与PBSC/CD 34组（P <0.001）和粒细胞集落刺激因子（G-CSF）治疗（P = 0.017）相关。血小板达到50 × 109/L的时间短与PBSC（P = 0.003）和无甲氨蝶呤（P = 0.015）相关。II-IV级急性移植物抗宿主病（GVHD）在BM对照组中为20%，在PBSC组中为30%，在CD 34组中为18%（不显著[NS]）。BM组慢性GVHD发生率为85%，PBSC组为59%，CD 34组为0%（P <0.01）。BM组和PBSC组的1年移植相关死亡率分别为21%和27%，存活率分别为53%和54%（NS）。两组2年无复发生存率分别为41%和46%。(C)1999年，美国血液学会。
Peripheral blood stem cell (PBSC) transplants from HLA-A, -B, and -DR compatible unrelated donors (n = 45) were compared with bone marrow (BM; BM group, n = 45). Eighteen patients received CD34-selected PBSC (CD34 group). The PBSCs contained more mononuclear cells, CD34(+), CD3(+), and CD56(+) cells compared with marrow (P < .001). Engraftment was achieved in all 45 patients in the BM group, in 43 of 45 (95%) in the PBSC group, and in 14 of 18 (78%) in the CD34 group (P < .01). In multivariate analysis, a short time to absolute neutrophil count (ANC) equal to 0.5 x 10(9)/L was associated with the PBSC/CD34 groups (P < .001) and granulocyte colony-stimulating factor (G-CSF) treatment (P = .017). A short time to platelets equal to 50 x 10(9)/L was associated with PBSC (P = .003) and no methotrexate (P = .015). Grades II-IV acute graft-versus-host disease (GVHD) was 20% in the BM controls, 30% in the PBSC group, and 18% in the CD34 group (not significant [NS]). The probability of chronic GVHD was 85% in the BM group, 59% in the PBSC group, and 0% in the CD34 group (P < .01). One-year transplant-related mortality was 21% and 27% and survival was 53% and 54% in the BM and PBSC groups, respectively (NS). The 2-year relapse-free survival was 41% and 46% in the two groups, respectively. (C) 1999 by The American Society of Hematology.