Transplantation of mobilized peripheral blood cells to HLA-identical siblings with standard-risk leukemia
Identifieur interne : 00B480 ( Main/Exploration ); précédent : 00B479; suivant : 00B481Transplantation of mobilized peripheral blood cells to HLA-identical siblings with standard-risk leukemia
Auteurs : Norbert Schmitz [Allemagne, Turquie, Italie, Finlande, Israël, Royaume-Uni, Australie, Suisse, France] ; Meral Beksac ; Dirk Hasenclever ; Andrea Bacigalupo ; Tapani Ruutu ; Arnon Nagler ; Eliane Gluckman ; Nigel Russell ; Jane F. Apperley ; Norbert C. Gorin ; Jeff Szer ; Ken Bradstock ; Agnes Buzyn ; Peter Clark ; Keith Borkett ; Alois GratwohlSource :
- Blood [ 0006-4971 ] ; 2002.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Cellule souche.
English descriptors
- KwdEn :
Abstract
Allogeneic mobilized peripheral blood progenitor cells instead of bone marrow are increasingly used to restore hematopolesis after myeloablative therapy. Data supporting this important change of clinical practice are scarce. We therefore assigned patients with early leukemias to peripheral blood or bone marrow transplantation; the occurrence of acute and chronic graft versus host disease, survival, transplantation-related mortality, and relapse rates were compared. A total of 350 patients between 18 and 55 years of age with acute leukemias in remission or chronic myelogenous leukemia in first chronic phase were randomized to receive either filgrastim-mobilized peripheral blood progenitor cells or bone marrow cells from HLA-identical sibling donors after standard high-dose chemoradiotherapy. Neutrophil and platelet recovery occurred significantly faster after transplantation of peripheral blood progenitor cells than after bone marrow transplantation. Acute graft versus host disease of grades II-IV was significantly more frequent in recipients of peripheral blood progenitor cells than in recipients of marrow cells (52% vs 39%, odds ratio 1.74, 95% confidence interval 1.12-2.69, P = .013). The cumulative incidence of chronic graft versus host disease was 67% with peripheral blood progenitor cells and 54% with bone marrow cells (hazard ratio 1.67, 95% confidence interval 1.15-2.42, P = .0066). The estimated overall probability of survival at 2 years was 65% with either source of stem cells (hazard ratio 1.15, 95% confidence Interval 0.79-1.67, P = .46). Disease-free survival, transplantation-related mortality at day 100, and relapse rates did not significantly differ between treatment arms. Peripheral blood is an equivalent source of hematopoietic stem cells compared with bone marrow if administered to patients with standard-risk leukemias. Long-term observation of patients with different diseases and stages of disease is necessary to ultimately define the role of both sources of stem cells.
Affiliations:
- Allemagne, Australie, Finlande, France, Israël, Italie, Royaume-Uni, Suisse, Turquie
- Angleterre, Grand Londres, Nouvelle-Galles du Sud
- Londres, Sydney
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Hematology, Hôpital St Antoine</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Hôpital St Antoine</wicri:noRegion><wicri:noRegion>Department of Hematology, Hôpital St Antoine</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Hôpital Necker, Service d'Hematologie/Adulte</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Service d'Hematologie/Adulte</wicri:noRegion><wicri:noRegion>Hôpital Necker, Service d'Hematologie/Adulte</wicri:noRegion></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name></author><author><name sortKey="Hasenclever, Dirk" sort="Hasenclever, Dirk" uniqKey="Hasenclever D" first="Dirk" last="Hasenclever">Dirk Hasenclever</name></author><author><name sortKey="Bacigalupo, Andrea" sort="Bacigalupo, Andrea" uniqKey="Bacigalupo A" first="Andrea" last="Bacigalupo">Andrea Bacigalupo</name></author><author><name 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Apperley</name></author><author><name sortKey="Gorin, Norbert C" sort="Gorin, Norbert C" uniqKey="Gorin N" first="Norbert C." last="Gorin">Norbert C. 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University of Kiel</s1><s3>DEU</s3></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Kiel</wicri:noRegion><wicri:noRegion>Department of Internal Medicine II, University of Kiel</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Hematology/Oncology, Ankara University</s1><s3>TUR</s3></inist:fA14><country>Turquie</country><wicri:noRegion>Department of Hematology/Oncology, Ankara University</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig</s1><s3>DEU</s3></inist:fA14><country>Allemagne</country><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Hematology, Ospedale San Martino</s1><s2>Genova</s2><s3>ITA</s3></inist:fA14><country>Italie</country><wicri:noRegion>Genova</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Medicine, Helsinki University Central Hospital</s1><s3>FIN</s3></inist:fA14><country>Finlande</country><wicri:noRegion>Department of Medicine, Helsinki University Central Hospital</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Bone Marrow Transplantation, Hadassah University Hospital</s1><s2>Jerusalem</s2><s3>ISR</s3></inist:fA14><country>Israël</country><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Nottingham City Hospital</s1><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Nottingham City Hospital</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Department of Hematology, Hammersmith Hospital</s1><s2>London</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Bone Marrow Transplant Service, The Royal Melbourne Hospital</s1><s2>Parkville</s2><s3>AUS</s3></inist:fA14><country>Australie</country><wicri:noRegion>Parkville</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Blood and Marrow Transplant Service, Westmead Hospital</s1><s2>Sydney</s2><s3>AUS</s3></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Amgen</s1><s2>Cambridge</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Amgen</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Kantonsspital</s1><s2>Basel</s2><s3>CHE</s3></inist:fA14><country>Suisse</country><wicri:noRegion>Kantonsspital</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Hematology, Hôpital St Louis</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Hôpital St Louis</wicri:noRegion><wicri:noRegion>Department of Hematology, Hôpital St Louis</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Department of Hematology, Hôpital St Antoine</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Hôpital St Antoine</wicri:noRegion><wicri:noRegion>Department of Hematology, Hôpital St Antoine</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Hôpital Necker, Service d'Hematologie/Adulte</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Service d'Hematologie/Adulte</wicri:noRegion><wicri:noRegion>Hôpital Necker, Service d'Hematologie/Adulte</wicri:noRegion></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name></author><author><name sortKey="Hasenclever, Dirk" sort="Hasenclever, Dirk" uniqKey="Hasenclever D" first="Dirk" last="Hasenclever">Dirk Hasenclever</name></author><author><name sortKey="Bacigalupo, Andrea" sort="Bacigalupo, Andrea" uniqKey="Bacigalupo A" first="Andrea" last="Bacigalupo">Andrea Bacigalupo</name></author><author><name sortKey="Ruutu, Tapani" sort="Ruutu, Tapani" uniqKey="Ruutu T" first="Tapani" last="Ruutu">Tapani Ruutu</name></author><author><name sortKey="Nagler, Arnon" sort="Nagler, Arnon" uniqKey="Nagler A" first="Arnon" last="Nagler">Arnon Nagler</name></author><author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name></author><author><name sortKey="Russell, Nigel" sort="Russell, Nigel" uniqKey="Russell N" first="Nigel" last="Russell">Nigel Russell</name></author><author><name sortKey="Apperley, Jane F" sort="Apperley, Jane F" uniqKey="Apperley J" first="Jane F." last="Apperley">Jane F. Apperley</name></author><author><name sortKey="Gorin, Norbert C" sort="Gorin, Norbert C" uniqKey="Gorin N" first="Norbert C." last="Gorin">Norbert C. Gorin</name></author><author><name sortKey="Szer, Jeff" sort="Szer, Jeff" uniqKey="Szer J" first="Jeff" last="Szer">Jeff Szer</name></author><author><name sortKey="Bradstock, Ken" sort="Bradstock, Ken" uniqKey="Bradstock K" first="Ken" last="Bradstock">Ken Bradstock</name></author><author><name sortKey="Buzyn, Agnes" sort="Buzyn, Agnes" uniqKey="Buzyn A" first="Agnes" last="Buzyn">Agnes Buzyn</name></author><author><name sortKey="Clark, Peter" sort="Clark, Peter" uniqKey="Clark P" first="Peter" last="Clark">Peter Clark</name></author><author><name sortKey="Borkett, Keith" sort="Borkett, Keith" uniqKey="Borkett K" first="Keith" last="Borkett">Keith Borkett</name></author><author><name sortKey="Gratwohl, Alois" sort="Gratwohl, Alois" uniqKey="Gratwohl A" first="Alois" last="Gratwohl">Alois Gratwohl</name></author></analytic><series><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood cell</term><term>Bone marrow</term><term>Graft versus host reaction</term><term>HLA-System</term><term>Hematopoietic cell</term><term>Homograft</term><term>Leukemia</term><term>Major histocompatibility system</term><term>Mobilization</term><term>Prognosis</term><term>Related donor</term><term>Stem cell</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Leucémie</term><term>Traitement</term><term>Moelle osseuse</term><term>Homogreffe</term><term>Cellule hématopoïétique</term><term>Cellule souche</term><term>Cellule sanguine</term><term>Donneur apparenté</term><term>Mobilisation</term><term>Système HLA</term><term>Système histocompatibilité majeur</term><term>Maladie greffon hôte</term><term>Pronostic</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cellule souche</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Allogeneic mobilized peripheral blood progenitor cells instead of bone marrow are increasingly used to restore hematopolesis after myeloablative therapy. Data supporting this important change of clinical practice are scarce. We therefore assigned patients with early leukemias to peripheral blood or bone marrow transplantation; the occurrence of acute and chronic graft versus host disease, survival, transplantation-related mortality, and relapse rates were compared. A total of 350 patients between 18 and 55 years of age with acute leukemias in remission or chronic myelogenous leukemia in first chronic phase were randomized to receive either filgrastim-mobilized peripheral blood progenitor cells or bone marrow cells from HLA-identical sibling donors after standard high-dose chemoradiotherapy. Neutrophil and platelet recovery occurred significantly faster after transplantation of peripheral blood progenitor cells than after bone marrow transplantation. Acute graft versus host disease of grades II-IV was significantly more frequent in recipients of peripheral blood progenitor cells than in recipients of marrow cells (52% vs 39%, odds ratio 1.74, 95% confidence interval 1.12-2.69, P = .013). The cumulative incidence of chronic graft versus host disease was 67% with peripheral blood progenitor cells and 54% with bone marrow cells (hazard ratio 1.67, 95% confidence interval 1.15-2.42, P = .0066). The estimated overall probability of survival at 2 years was 65% with either source of stem cells (hazard ratio 1.15, 95% confidence Interval 0.79-1.67, P = .46). Disease-free survival, transplantation-related mortality at day 100, and relapse rates did not significantly differ between treatment arms. Peripheral blood is an equivalent source of hematopoietic stem cells compared with bone marrow if administered to patients with standard-risk leukemias. Long-term observation of patients with different diseases and stages of disease is necessary to ultimately define the role of both sources of stem cells.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Finlande</li><li>France</li><li>Israël</li><li>Italie</li><li>Royaume-Uni</li><li>Suisse</li><li>Turquie</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Nouvelle-Galles du Sud</li></region><settlement><li>Londres</li><li>Sydney</li></settlement></list><tree><noCountry><name sortKey="Apperley, Jane F" sort="Apperley, Jane F" uniqKey="Apperley J" first="Jane F." last="Apperley">Jane F. Apperley</name><name sortKey="Bacigalupo, Andrea" sort="Bacigalupo, Andrea" uniqKey="Bacigalupo A" first="Andrea" last="Bacigalupo">Andrea Bacigalupo</name><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name><name sortKey="Borkett, Keith" sort="Borkett, Keith" uniqKey="Borkett K" first="Keith" last="Borkett">Keith Borkett</name><name sortKey="Bradstock, Ken" sort="Bradstock, Ken" uniqKey="Bradstock K" first="Ken" last="Bradstock">Ken Bradstock</name><name sortKey="Buzyn, Agnes" sort="Buzyn, Agnes" uniqKey="Buzyn A" first="Agnes" last="Buzyn">Agnes Buzyn</name><name sortKey="Clark, Peter" sort="Clark, Peter" uniqKey="Clark P" first="Peter" last="Clark">Peter Clark</name><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name><name sortKey="Gorin, Norbert C" sort="Gorin, Norbert C" uniqKey="Gorin N" first="Norbert C." last="Gorin">Norbert C. Gorin</name><name sortKey="Gratwohl, Alois" sort="Gratwohl, Alois" uniqKey="Gratwohl A" first="Alois" last="Gratwohl">Alois Gratwohl</name><name sortKey="Hasenclever, Dirk" sort="Hasenclever, Dirk" uniqKey="Hasenclever D" first="Dirk" last="Hasenclever">Dirk Hasenclever</name><name sortKey="Nagler, Arnon" sort="Nagler, Arnon" uniqKey="Nagler A" first="Arnon" last="Nagler">Arnon Nagler</name><name sortKey="Russell, Nigel" sort="Russell, Nigel" uniqKey="Russell N" first="Nigel" last="Russell">Nigel Russell</name><name sortKey="Ruutu, Tapani" sort="Ruutu, Tapani" uniqKey="Ruutu T" first="Tapani" last="Ruutu">Tapani Ruutu</name><name sortKey="Szer, Jeff" sort="Szer, Jeff" uniqKey="Szer J" first="Jeff" last="Szer">Jeff Szer</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></country><country name="Turquie"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion></country><country name="Finlande"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion></country><country name="Israël"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></country><country name="Australie"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></country><country name="Suisse"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion></country><country name="France"><noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></noRegion><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name><name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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