Journal of Clinical Oncology, Vol 18, Issue 3
(February), 2000: 537
© 2000 American Society for Clinical Oncology
Randomized Trial of Bone Marrow Versus Lenograstim-Primed Blood Cell Allogeneic Transplantation in Patients With Early-Stage Leukemia: A Report From the Société Française de Greffe de Moelle
By Didier Blaise,
Mathieu Kuentz,
Cecile Fortanier,
Jean Henri Bourhis,
Noël Milpied,
Laurent Sutton,
Jean-Pierre Jouet,
Michel Attal,
Pierre Bordigoni,
Jean-Yves Cahn,
Jean-Michel Boiron,
Marie-Pascale Schuller,
Jean-Paul Moatti,
Mauricette Michallet
From the Société Française de Greffe de Moelle, Lyon, France.
Address reprint requests to Didier Blaise, MD, Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli Calmettes, 232 Bd Ste Marguerite, 13273 Marseille Cedex 9, France; email blaised@ marseille.fnclcc.fr.
PURPOSE: To compare hematologic recovery in patients receiving allogeneic blood cell transplantation (BCT) with those receiving allogeneic bone marrow transplantation (BMT).
PATIENTS AND METHODS: One hundred eleven patients with leukemia in the early stages and with HLA-matched sibling donors were randomized in this study. One hundred one underwent transplantation. Standard procedures for collection and transplantation were used. Patients did not receive prophylactic granulocyte colony-stimulating factor after undergoing transplantation. In addition to clinical end points being established, a prospective and comparative economic evaluation of the first 6 months after transplantation was performed.
RESULTS: Groups were balanced for patient, donor, and transplant characteristics. Blood cell collection led to the collection of a higher number of CD34+ and CD3+ cells than did bone marrow collection (P < 10-6) without reported side effects for the donor. Patients in the BCT group reached platelet counts of 25 and 50 x 109 platelets/L 8 and 11 days earlier than did the BMT group (P < 10-4 and P < 10-5), respectively. This resulted in fewer platelet transfusions during the first 180 days after transplantation (P = .002) for the former group. The time to reach neutrophil counts of 0.5 and 1 x 109 neutrophils/L was 6 and 7 days shorter, respectively, in the BCT group than in the BMT group (P < 10-5). This quicker hematologic recovery was associated with a shorter length of hospitalization and a decrease in total cost of procedure during the first 6 months.
CONCLUSION: This study establishes that allogeneic BCT results in quicker hematologic recovery but is associated with a higher occurrence of chronic graft-versus-host disease.
D. Blaise, M. Kuentz, and M. Michallet contributed equally to this work.
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