Lin DY. Randomized trial of allogeneic related bone marrow transplantation versus peripheral blood stem cell transplantation for chronic myeloid leukemia. Spellman S, Bray R, Rosen-Bronson S, et al. Patients were randomly assigned in a 1:1 ratio to peripheral-blood stem-cell or bone marrow transplantation, stratified according to transplantation center and disease risk. Yes. When stem cell transplants were first developed, the new stem cells came from bone marrow, and so this was known as a bone marrow transplant. The primary analysis was planned as a pointwise comparison of overall survival at 2 years rather than as a log-rank test because of concerns about nonproportional hazards between the two groups. In addition, a planned secondary analysis of outcomes was conducted with the use of Cox regression to adjust for the characteristics of the patients. Bone marrow cells were collected from the donors by means of standard procedures. ); University of Minnesota Medical Center, Minneapolis (D.J.W. An autologous transplantation is when a patient uses cells from their own body. Blood 1995;85:1659-1665, 4. The primary comparison of 2-year survival was performed with the use of a stratified binomial comparison (Mantel–Haenszel test), stratified according to transplantation center and disease risk. Stay connected to what's important in medical research and clinical practice, Subscribe to the most trusted and influential source ofmedical knowledge. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor. Blood 2007;110:4576-4583, 18. J Clin Oncol 2005;23:5074-5087, 25. Outcomes after Transplantation, According to Study Group. Blood 2010;115:2704-2708, 21. These diseases accounted for approximately 75% of unrelated-donor transplantations in the United States during the study period. Allogeneic peripheral blood stem-cell compared with bone marrow transplantation in the management of hematologic malignancies: an individual patient data meta-analysis of nine randomized trials. Five percent of the patients randomly assigned to the bone marrow group and 4% of those randomly assigned to the peripheral-blood group did not undergo transplantation but were included in the intention-to-treat analysis. In the early days of allogeneic hematopoietic stem-cell transplantation, the only graft source available was bone marrow harvested from the pelvis of a donor under anesthesia. Clin Transpl 2010;2010:87-105, 24. Blaise D, Kuentz M, Fortanier C, et al. The P value from a stratified log-rank test was also not significant. ); University of Texas M.D. Stem cells are made in the bone marrow and develop into the different types of blood cells in the body. Exclusion criteria were donor-specific anti-HLA antibodies, prior allogeneic or autologous transplantation, human immunodeficiency virus infection, pregnancy or breast-feeding, cardiac insufficiency or coronary artery disease requiring treatment, active infection, or concomitant enrollment in a phase 1 study. The median follow-up of surviving patients was 36 months (interquartile range, 30 to 37). Health-related quality-of-life among adult matched unrelated stem cell donors: a Blood and Marrow Transplant Clinical Trials Network (BMT CTN) randomized trial of marrow versus PBSC donation. The 2-year overall survival rate in the peripheral-blood group was 51% (95% confidence interval [CI], 45 to 57), as compared with 46% (95% CI, 40 to 52) in the bone marrow group (stratified odds ratio, 1.20; 95% CI, 0.85 to 1.70; P=0.29) (Figure 1). — both in Canada; University Hospital Dresden, Dresden, Germany (G.E. The study was an open-label, phase 3, multicenter, randomized trial conducted by the Blood and Marrow Transplant Clinical Trials Network. Bone marrow transplants are now also known as hematopoietic stem cell transplants. Donor preference may also affect the choice of stem-cell source. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Welcome to your home for all things Mayo Clinic Hematology. Peripheral-Blood Stem Cells versus Bone Marrow from Unrelated Donors. Non-parametric inference for cumulative incidence functions in competing risks. Patients were followed in the study for 3 years, with a late analysis at 5 years planned with the use of data from the Center for International Blood and Marrow Transplant Research, which tracks the outcomes of all allogeneic transplantations in the United States. There was no predefined anticipated direction of the survival difference between the two treatment groups. This large, multicenter, randomized trial did not show a significant survival difference between transplant recipients who received peripheral-blood stem cells and those who received bone marrow from unrelated donors.

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