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Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: a propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry

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Abstract

We retrospectively analyzed the results of 707 adult patients who underwent myeloablative peripheral blood stem cell transplantation (PBSCT) (n = 365) and myeloablative bone marrow transplantation (BMT) (n = 342) for leukemia from HLA-identical sibling donors between 2000 and 2005 using the propensity score method. The results were obtained from the Japan Society for Hematopoietic Cell Transplantation registry. Multivariate Cox analysis showed that PBSCT was associated with lower overall survival (OS) in standard-risk patients [adjusted hazard ratio (aHR) = 1.83; 95% confidence interval (CI) 1.04–3.23; P = 0.036], but not in high-risk patients (aHR = 1.11; 95% CI 0.76–1.61; P = 0.599). Hematopoietic recovery was significantly faster after PBSCT. The risk of acquiring grade III–IV acute graft-versus-host disease (GVHD) (aHR = 2.23; P = 0.040) and extensive chronic GVHD (aHR = 1.93; P = 0.001) were significantly higher after PBSCT. PBSCT was associated with higher non-relapse mortality in standard-risk patients (aHR = 2.30; 95% CI 1.08–4.88; P = 0.030), but not in high-risk patients (aHR = 1.29; 95% CI 0.65–2.54; P = 0.468). Relapse after transplantation did not differ between PBSCT and BMT either in standard-risk group or in high-risk group (aHR = 1.17; 95% CI 0.55–2.52; P = 0.684 and aHR = 0.81; 95% CI 0.52–1.28; P = 0.370, respectively). In this retrospective analysis, OS was significantly lower after PBSCT in standard-risk patients, but not in high-risk patients. PBSCT was associated with significant risks of grade III–IV acute GVHD and extensive chronic GVHD.

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Conflict of interest statement

The authors declare no financial conflict of interest.

Author information

Authors and Affiliations

  1. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    Koji Nagafuji & Mine Harada

  2. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Keitaro Matsuo

  3. Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan

    Takanori Teshima

  4. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Shin-ichiro Mori

  5. Department of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Hisashi Sakamaki

  6. Department of Internal Medicine, Kumamoto Medical Center, National Hospital Organization, Kumamoto, Japan

    Michihiro Hidaka

  7. Department of Molecular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroyasu Ogawa

  8. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yoshihisa Kodera

  9. Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Yoshinobu Kanda

  10. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Atsuo Maruta

  11. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Takehiko Mori

  12. Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan

    Fumiaki Yoshiba

  13. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Tatsuo Ichinohe

  14. Department of Hematology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Masanobu Kasai

  15. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

    Yoshifusa Takatsuka

  16. Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan

    Kohmei Kubo

  17. Department of Hematology, Meitetsu Hospital, Nagoya, Japan

    Hiroshi Sao

  18. Department of HSCT Data Management, Nagoya University School of Medicine, Nagoya, Japan

    Yoshiko Atsuta & Ritsuro Suzuki

  19. Hematology Department, Toyama Prefectural Hospital, Toyama, Japan

    Takashi Yoshida

  20. Department of Pediatrics, Ibaraki Children’s Hospital, Mito, Japan

    Masahiro Tsuchida

  21. Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan

    Koji Nagafuji

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  1. Koji Nagafuji
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  22. Mine Harada
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Correspondence to Koji Nagafuji.

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Nagafuji, K., Matsuo, K., Teshima, T. et al. Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: a propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry. Int J Hematol 91, 855–864 (2010). https://doi.org/10.1007/s12185-010-0581-1

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