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Studies Investigate New Methodologies to Improve Recovery and Survival Strategies for Patients Undergoing Hematopoietic Cell Transplantation
Date:12/10/2011

two transplant sources that has prospectively analyzed patient outcomes in unrelated donor transplants.

To determine whether graft source – PBSCs or bone marrow – affects transplant outcomes in unrelated donor transplants for patients with leukemia or other hematologic malignancies, the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) conducted a clinical trial, BMT CTN Protocol 0201, to compare two-year survival probabilities for patients transplanted with PBSCs or bone marrow stem cells from unrelated donors. Fifty transplant centers in the United States and Canada participated in this large, Phase III, prospective, multicenter study which randomized patients to receive bone marrow (n=278) or PBSCs (n=273) as the graft source for transplant.

According to the trial analyses, there were no observed differences in overall survival, relapse, non-relapse mortality, or acute GVHD between the patients receiving PBSCs or bone marrow stem cells from unrelated donors. While engraftment was faster in patients receiving PBSCs, there was a higher incidence of overall chronic GVHD in these patients (53%) than in those transplanted with bone marrow stem cells (40%). Patients receiving transplants of PBSCs from unrelated donors also had a higher incidence of chronic extensive GVHD (46%) than patients who received bone marrow stem cells (31%).

"Although PBSCs from related donors have demonstrated clinical benefits, our trial demonstrates that when these stem cells originate from unrelated donors they are not superior to bone marrow stem cells in terms of patient survival, and they increase the risk for chronic GVHD," said lead author Claudio Anasetti, MD, Chair of the Department of Blood & Marrow Transplant at Moffitt Cancer Center in Tampa, Fla. "More effective strategies to prevent GVHD are needed to improve outcomes for all patients receiving unrelated donor transplants."

This trial was supported by the National Hea
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SOURCE American Society of Hematology
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