PBSCT is associated with poorer survival and increased chronic GvHD than BMT in Japanese paediatric patients with acute leukaemia and an HLA-matched sibling donor

Aki Shinzato, Ken Tabuchi, Yoshiko Atsuta, Masami Inoue, Jiro Inagaki, Hiromasa Yabe, Katsuyoshi Koh, Koji Kato, Hideaki Ohta, Hisato Kigasawa, Toshiyuki Kitoh, Atsushi Ogawa, Yoshiyuki Takahashi, Yoji Sasahara, Shun Ichi Kato, Souichi Adachi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Peripheral blood stem cells (PBSC) may be used as an alternative to bone marrow (BM) for allogeneic transplantation. Since peripheral blood stem cell bank from unrelated volunteer donor has been started in Japan, use of PBSC allografts may be increased. Therefore we surveyed the outcomes of Japanese leukemia children after PBSC and BM transplantation. Procedure: This retrospective study compared the outcomes of 661 children (0-18 years) with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML) who received their first allogeneic peripheral blood stem cell transplantation (PBSCT; n=90) or bone marrow transplantation (BMT; n=571) from HLA-matched siblings between January 1996 and December 2007. Result: Neutrophil recovery was faster after PBSCT than after BMT (ALL: P<0.0001; AML: P=0.0002), as was platelet recovery (ALL: P=0.0008; AML: P=0.0848). However, the cumulative incidence of chronic graft-versus-host disease (GvHD) was higher after PBSCT than after BMT (ALL: 26.0% vs. 9.9%, P=0.0066; AML: 41.6% vs. 11.1%, P<0.0001). The 5-year disease-free survival (DFS) was lower after PBSCT than after BMT for ALL (40.6% vs. 57.1%, P=0.0257). The 5-year overall survival (OS) was lower after PBSCT than after BMT for ALL (42.4% vs. 63.7%, P=0.0032) and AML (49.8% vs. 71.8%, P=0.0163). Multivariate analysis revealed the use of PBSC was a significant risk factor for DFS and OS. PBSCT and BMT did not differ in relapse rate, acute GvHD for ALL and AML, or in DFS for AML. Conclusion: PBSC allografts in Japanese children engraft faster but are associated with poorer survival and increased chronic GvHD.

Original languageEnglish
Pages (from-to)1513-1519
Number of pages7
JournalPediatric Blood and Cancer
Volume60
Issue number9
DOIs
Publication statusPublished - 2013 Sep

Keywords

  • Acute leukaemia
  • Bone marrow transplantation
  • Children
  • Chronic graft-versus-host disease
  • Peripheral blood stem cell transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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