Hong Kong Med J 2009;15(Suppl 3):S31-4
Long-term outcome of allogeneic human leukocyte antigen-matched sibling-donor peripheral blood stem cell transplantation in leukaemia patients
JL Tang, M Yao, MY Lu, BS Ko, DT Lin, KH Lin, YC Chen
National Taiwan University Hospital Department of Internal Medicine
Between 1993 and July 2008, a total of 354 leukaemic patients received either allogeneic bone marrow transplantation (BMT) [n=180] or peripheral blood stem cell transplantation (PBSCT) [n=174] from human leukocyte antigen–matched sibling donors. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and methotrexate. When comparing with BMT group, patients in the PBSCT group received much higher nucleated cells and CD34+ cells, and had much faster recovery of the neutrophil and platelet counts. The probability of developing acute GVHD was slightly higher in PBSCT patients (P=0.02). The probability of chronic GVHD (cGVHD) in PBSCT was much higher in PBSCT (70±5.4%, extensive 48±6.5%) than in BMT (25±4.7%, extensive 10±3.4%; P<0.001). Chronic GVHD was associated with long-term impairment of life quality and decreased quality-adjusted survival. In standard-risk leukaemia, use of PBSCT was associated with higher cGVHD, transplant-related mortality and a trend for decreased overall survival. The results suggest that allogeneic PBSCT is associated with high incidence of cGVHD in Chinese patients and its long-term risk and benefit remains to be defined in early stage of leukaemia.