The role of stem cell source in autologous hematopoietic stem cell transplantation for patients with myelodysplastic syndromes.
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The role of stem cell source in autologous hematopoietic stem cell transplantation for patients with myelodysplastic syndromes. / de Witte, Theo; Brand, Ronald; van Biezen, Anja; Delforge, Michel; Biersack, Harold; Or, Reuven; Meloni, Giovanna; Bandini, Beppe; Sierra, Jorge; Kröger, Nicolaus; Gratwohl, Alois; Niederwieser, Dietger.
In: HAEMATOLOGICA, Vol. 91, No. 6, 6, 2006, p. 750-756.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The role of stem cell source in autologous hematopoietic stem cell transplantation for patients with myelodysplastic syndromes.
AU - de Witte, Theo
AU - Brand, Ronald
AU - van Biezen, Anja
AU - Delforge, Michel
AU - Biersack, Harold
AU - Or, Reuven
AU - Meloni, Giovanna
AU - Bandini, Beppe
AU - Sierra, Jorge
AU - Kröger, Nicolaus
AU - Gratwohl, Alois
AU - Niederwieser, Dietger
PY - 2006
Y1 - 2006
N2 - BACKGROUND AND OBJECTIVES: Intensive chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) is a curative treatment option for patients with myelodysplastic syndromes (MDS). Peripheral blood (PB) HSCT was introduced in 1992 and PB has become the source of choice of autologous stem cells worldwide. Autologous PB stem cells result in faster hematopoietic recovery, but may be associated with a higher risk of relapse. DESIGN AND METHODS: We analyzed the data of 336 patients transplanted after 1992 with either bone marrow (BM) (n=104) or PB (n=232). RESULTS: Various factors had an impact on event-free survival in univariate analysis: age hazard ratio [HR]=1.1 per 10 years; p=0.12), source of stem cells (HR=1.2, p=0.22), interval between diagnosis and transplantation (HR=1.0 per month; p=0.87), and therapy-related vs primary disease (HR=0.5; p=0.002). In the multivariate Cox model, the event-free survival was not different after PB or BM HSCT with a HR of 0.93 (95% confidence interval of 0.67 - 1.30; p=0.67). The relapse risk after transplantation with stem cells from either source was similar with a HR of 1.1. A significant interaction (p=0.02) between age and the source of stem cells indicated a more favorable potential of autologous PB HSCT in young age groups. INTERPRETATION AND CONCLUSIONS: Autologous PB and BM HSCT result in equivalent outcomes. Therefore, given the more rapid hematopoietic recovery PB is the preferred source of stem cells.
AB - BACKGROUND AND OBJECTIVES: Intensive chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) is a curative treatment option for patients with myelodysplastic syndromes (MDS). Peripheral blood (PB) HSCT was introduced in 1992 and PB has become the source of choice of autologous stem cells worldwide. Autologous PB stem cells result in faster hematopoietic recovery, but may be associated with a higher risk of relapse. DESIGN AND METHODS: We analyzed the data of 336 patients transplanted after 1992 with either bone marrow (BM) (n=104) or PB (n=232). RESULTS: Various factors had an impact on event-free survival in univariate analysis: age hazard ratio [HR]=1.1 per 10 years; p=0.12), source of stem cells (HR=1.2, p=0.22), interval between diagnosis and transplantation (HR=1.0 per month; p=0.87), and therapy-related vs primary disease (HR=0.5; p=0.002). In the multivariate Cox model, the event-free survival was not different after PB or BM HSCT with a HR of 0.93 (95% confidence interval of 0.67 - 1.30; p=0.67). The relapse risk after transplantation with stem cells from either source was similar with a HR of 1.1. A significant interaction (p=0.02) between age and the source of stem cells indicated a more favorable potential of autologous PB HSCT in young age groups. INTERPRETATION AND CONCLUSIONS: Autologous PB and BM HSCT result in equivalent outcomes. Therefore, given the more rapid hematopoietic recovery PB is the preferred source of stem cells.
M3 - SCORING: Zeitschriftenaufsatz
VL - 91
SP - 750
EP - 756
JO - HAEMATOLOGICA
JF - HAEMATOLOGICA
SN - 0390-6078
IS - 6
M1 - 6
ER -