Bone Marrow, Peripheral Blood Equally Good for Transplantation


Stem cell transplantation survival rates are pretty much the same whether the graft comes from bone marrow or peripheral blood, according to the findings of a large randomized trial conducted by Claudio Anasetti, MD, of the H. Lee Moffitt Cancer Center in Tampa and colleagues, and reported in the New England Journal of Medicine.

Currently, as many as three out of every four transplants are done using peripheral blood stem cells, despite a dearth of evidence supporting their use over cells from bone marrow.

Researchers found no significant difference in overall survival at a two-year follow-up between the two sources of transplanted stem cells.

Each option reduces a risk

What they also found was the patients receiving cells from peripheral blood were at a reduced risk of graft failure, while patients receiving stem cells from bone marrow were at lowered risk of developing the potentially fatal complication known as graft-versus-host disease (GVHD).

This information can prove helpful for doctors trying to determine which source is right for which patient.

"Specific characteristics of the patients may suggest the preferential use of peripheral blood stem cells or bone marrow."

For instance, patients who have had no chemotherapy are at increased risk of graft failure and therefore might do better with peripheral cells, while patients immunosuppressed by chemotherapy would benefit from stem cells from bone marrow.

Despite enrolling 551 patients at 48 centers, a notable limitation of the study was that it only featured patients diagnosed with either leukemia or chronic myeloid disorders.

Source: Med Page Today

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