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A randomized multicenter comparison of bone marrow and peripheral blood in recipients of matched sibling allogeneic transplants for myeloid malignancies

Stephen Couban, David R. Simpson, Michael J. Barnett, Christopher Bredeson, Lothar Hubesch, Kang Howson-Jan, Tsiporah B. Shore, Irwin R. Walker, Peter Browett, Hans A. Messner, Tony Panzarella and Jeffrey H. Lipton

Article Figures & Data

Figures

Tables

  • Table 1.

    Donor and patient characteristics according to transplantation arm

    Bone marrow (n = 118)Peripheral blood (n = 109)
    Donor age, y44  (13-74)43  (17-67)
    Patient age, y44  (19-64)45  (19-64)
    CMV-seronegative patient and donor40  (34%)30  (28%)
    CML55  (47%)54  (49%)
     CP-149  (42%)46  (42%)
     > CP-1, AP6  (5%)8  (7%)
    AML43  (36%)39  (36%)
     CR-133  (28%)29  (27%)
     > CR-19  (8%)9  (8%)
    MDS20  (17%)16  (15%)
    Early disease* 87  (74%)78  (72%)
    Advanced disease 31  (26%)31  (28%)
    • Data are presented as median (range) or n (%).

    • CP-1 indicates first chronic phase; AP, accelerated phase; and CR-1, first complete remission.

    • * Early disease: AML CR-1, CML CP-1, refractory anemia, and refractory anemia with ringed sideroblasts.

    • Advanced disease: AML beyond CR-1, CML beyond CP-1 and AP, refractory anemia with excess blasts, and refractory anemia with excess blasts in transformation.

    • One patient with AML for whom disease status at transplantation was not known.

  • Table 2.

    Bone marrow and peripheral blood harvest characteristics according to transplantation arm

    Bone marrow (n = 118)Peripheral blood (n = 109)
    First collectionSecond collectionTotal
    Volume, mL1000138131283
    (50-1616)(50-1150)(37-381)(115-1334)
    CD34+ cells/kg patient 2.42.53.76.4
     weight × 106 (0.1-14.3)(0.1-16.1)(0.1-18.7)(0.7-32.0)
    CD3+ cells/kg patient 0.31.91.73.7
     weight × 108 (0.01-1.6)(0.3-27.1)(0.02-6.0)(1.2-30.8)
    • Data are presented as median (range).

  • Table 3.

    Secondary outcomes related to hematologic recovery according to transplantation arm

    Bone marrow (n = 118)Peripheral blood (n = 109)P3-150
    Red blood cell transfusions3-151 6  (0-74)4  (0-53).23
    Platelet transfusions3-151 6  (0-107)3  (0-74)< .0001
    Febrile days during first 30 days after transplantation4  (0-30)3  (0-23).66
    Days on nonprophylactic antibiotics from day 0 to first discharge17  (1-127)14  (3-59).001
    Days in hospital from day 0 to first discharge28  (13-156)25  (9-82).0006
    Days in hospital during first 100 days after transplantation32  (0-100)28  (16-90).09
    • Data are presented as median (range).

    • F3-150 Wilcoxon rank sum test.

    • F3-151 Number of transfusions during the first 60 days after transplantation. One red blood cell transfusion refers to one unit of packed red blood cells. One platelet transfusion refers to 4 to 6 pooled random donor units or one apheresis unit.

  • Table 4.

    Relapse and nonrelapse mortality according to transplantation arm

    Bone marrow (n = 118)Peripheral blood (n = 109)
    Total number of deaths4933
    Number of deaths in relapse1110
    Number of nonrelapse deaths3823
     Days 0-3093
     Days 31-10074
     After day 1002216