More chronic GvHD and non-relapse mortality after peripheral blood stem cell compared with bone marrow in hematopoietic transplantation for paediatric acute lymphoblastic leukemia: a retrospective study on behalf of the EBMT Paediatric Diseases Working Party

Simonin, Mathieu; Dalissier, Arnaud; Labopin, Myriam; Willasch, André; Zecca, Marco; Mouhab, Ayas; Chybicka, Alicja; Balduzzi, Adriana; Volin, Liisa; Peters, Christina; Bader, Peter; Dalle, Jean Hugues

doi:10.1038/bmt.2017.66

Cited by 23 publications

(19 citation statements)

References 11 publications

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“…Both myeloid and platelet engraftment occurred significantly earlier after MSD HSCT compared with after MD HSCT, in which the lower degree of HLA compatibility and the addition of MTX possibly could have played a role in delaying engraftment. Furthermore, myeloid engraftment was similar in MSD graft recipients, regardless of the source, but faster after PB compared with after BM in MD graft recipients [25].…”

Section: Discussionmentioning

confidence: 81%

“…In 2004, Eapen et al [34] reported a retrospective pediatric study that found a higher risk of cGVHD in the PB HSCT group, with no advantage in survival or relapse reduction. A more recent study from the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation reported a significantly lower 3-year EFS (54% versus 59%; P= .0007) and higher NRM (12% versus 20% [P = .0002]; HR, 1.91 [P = .001]) and cGVHD (HR, 1.91; P = .001) after PB HSCT compared with BM HSCT [25].…”

Section: Discussionmentioning

confidence: 99%

“…Such a finding does not allow ruling out the possibility that potentiating GVHD prophylaxis in MSD HSCT might increase the probability of relapse. A minimum change would consist of the addition of MTX for all MSD graft recipients, not only for PB recipients, whereas a deeper change would consist of the addition of another immunosuppressive drug, like sirolimus, or serotherapy [25,28,35].…”

Section: Discussionmentioning

confidence: 99%

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Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia from a Matched Donor versus an HLA-Identical Sibling: Is the Outcome Comparable? Results from the International BFM ALL SCT 2007 Study

Balduzzi

Dalle²,

Wachowiak

et al. 2019

Biology of Blood and Marrow Transplantation

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Eligibility criteria for hematopoietic stem cell transplantation (HSCT) in acute lymphoblastic leukemia (ALL) vary according to disease characteristics, response to treatment, and type of available donor. As the risk profile of the patient worsens, a wider degree of HLA mismatching is considered acceptable. A total of 138 children and adolescents who underwent HSCT from HLA-identical sibling donors (MSDs) and 210 who underwent HSCT from matched donors (MDs) (median age, 9 years; 68% male) in 10 countries were enrolled in the International-BFM ALL SCT 2007 prospective study to assess the impact of donor type in HSCT for pediatric ALL. The 4-year event-free survival (65 § 5% vs 61 § 4%; P = .287), overall survival (72 § 4% versus 68 § 4%; P = .235), cumulative incidence of relapse (24 § 4% versus 25 § 3%; P = .658) and nonrelapse mortality (10 § 3% versus 14 § 3%; P = .212) were not significantly different between MSD and MD graft recipients. The risk of extensive chronic (cGVHD) was lower in MD graft recipients than in MSD graft recipients (hazard ratio [HR], .38; P = .002), and the risks of severe acute GVHD (aGVHD) and cGVHD were higher in peripheral blood stem cell graft recipients than in bone marrow graft recipients (HR, 2.06; P = .026). Compared with the absence of aGVHD, grade I-II aGVHD was associated with a lower risk of graft failure (HR, .63; P = .042) and grade III-IV aGVHD was associated with a higher risk of graft failure (HR, 1.85; P = .020) and nonleukemic death (HR, 8.76; P < .0001), despite a lower risk of relapse (HR, .32; P = .021). Compared with the absence of cGVHD, extensive cGVHD was associated with a higher risk of nonleukemic death (HR, 8.12; P < .0001). Because the outcomes of transplantation from a matched donor were not inferior to those of transplantation from an HLA-identical sibling, eligibility criteria for transplantation might be reviewed in pediatric ALL and possibly in other malignancies as well. Bone marrow should be the preferred stem cell source, and the addition of MTX should be considered in MSD graft recipients.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia from a Matched Donor versus an HLA-Identical Sibling: Is the Outcome Comparable? Results from the International BFM ALL SCT 2007 Study

Balduzzi

Dalle²,

Wachowiak

et al. 2019

Biology of Blood and Marrow Transplantation

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“…We found no randomized controlled trials and could not exclude the influence of cofounding factors. Our analysis cohort is dominant in a study by Simonin et al [22] comprising only patients with Figure 2. Forest plots of 5-year OS.…”

Section: Discussionmentioning

confidence: 99%

Allogeneic Bone Marrow Transplantation versus Peripheral Blood Stem Cell Transplantation for Hematologic Malignancies in Children: A Systematic Review and Meta-Analysis

Shimosato

Tanoshima

Tsujimoto

et al. 2020

Biology of Blood and Marrow Transplantation

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Peripheral blood stem cell transplantation (PBSCT) is being increasingly performed as an alternative to bone marrow transplantation (BMT); however, PBSCT has not been proven to have equivalent outcome to BMT. We conducted a meta-analysis to compare survival rates and treatment-related complications between PBSCT and BMT for pediatric hematologic malignancies. We searched Medline, Embase plus Embase classics, and the Cochrane Central Register of Controlled Trials for the terms "hematopoietic stem cell transplantation" AND "allogeneic transplantation" AND "children", including randomized controlled studies and cohort studies without language limitations. We identified 7 of 5368 studies for inclusion in our meta-analysis. The cohorts of these studies included a total of 4328 patients, 3185 who underwent BMT and 1143 who underwent PBSCT. Five-year overall survival was similar in the 2 groups (PBSCT, 56.2%; BMT, 63.5%; relative risk [RR], 1.17; 95% confidence interval [CI], .91 to 1.52), as was the 5-year event-free survival (PBSCT, 49.9%; BMT, 57.2%; RR, 1.14; 95% CI, .93 to 1.39). The incidences of nonrelapse mortality and chronic graft-versus-host disease were higher in the PBSCT group compared with the BMT group (RR, 1.73; 95% CI, 1.50 to 1.99 versus RR, 1.55; 95% CI, 1.18 to 2.03). This meta-analysis found insufficient evidence to conclude that peripheral blood stem cells are equivalent to bone marrow. The results indicate that bone marrow can still be a preferred donor source for pediatric hematologic malignancies.

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“…Most of the haematopoietic stem cell transplantations use PBSC . However, BM harvest is still an important HSC source for transplantation in certain medical scenarios, such as bone marrow failure or haematopoietic stem cell transplantation in children . Marrow can also be used with success in haploidentical transplantation, and with increase in this type of the procedures, we can expect increase in bone marrow harvests (BMH) in related donors.…”

Section: Introductionmentioning

confidence: 99%

Bone marrow harvest in donors with anaemia

et al. 2018

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More chronic GvHD and non-relapse mortality after peripheral blood stem cell compared with bone marrow in hematopoietic transplantation for paediatric acute lymphoblastic leukemia: a retrospective study on behalf of the EBMT Paediatric Diseases Working Party

Cited by 23 publications

References 11 publications

Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia from a Matched Donor versus an HLA-Identical Sibling: Is the Outcome Comparable? Results from the International BFM ALL SCT 2007 Study

Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia from a Matched Donor versus an HLA-Identical Sibling: Is the Outcome Comparable? Results from the International BFM ALL SCT 2007 Study

Allogeneic Bone Marrow Transplantation versus Peripheral Blood Stem Cell Transplantation for Hematologic Malignancies in Children: A Systematic Review and Meta-Analysis

Bone marrow harvest in donors with anaemia

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