Featured Research

from universities, journals, and other organizations

Blood Transplants May Be More Harmful Than Bone Marrow Transplants In Pediatric Leukemia Patients

Date:
November 11, 2004
Source:
American Society Of Clinical Oncology
Summary:
A new study has shown for the first time that transplantation of peripheral blood stem cells (PBSC) from sibling donors may be more harmful than bone marrow in pediatric leukemia patients.

Alexandria, VA -- A new study has shown for the first time that transplantation of peripheral blood stem cells (PBSC) from sibling donors may be more harmful than bone marrow in pediatric leukemia patients.

Researchers from the International Bone Marrow Transplant Registry (IBMTR) found that patients undergoing PBSC transplants were more likely to die of transplant-related causes than those who underwent bone marrow transplants. It is estimated that nearly 30% of transplants from sibling donors in pediatric patients now use peripheral blood stem cells. The study and an accompanying editorial will be published November 1 in the Journal of Clinical Oncology (JCO).

"Our data support the use of bone marrow for transplantation in these patients when a matched sibling donor is available," said Mary Eapen, MBBS, MS, Assistant Professor at the Medical College of Wisconsin and lead author of the study. "The higher rates of mortality observed after PBSC transplantation compared to bone marrow transplantation should serve as a cautionary note, and underscore the urgent need for a properly designed clinical trial to define the role, if any, of donor peripheral blood stem cell transplantation in children."

<b>Background</b>

Leukemia is cancer of the bone marrow. Bone marrow transplants involve the collection from the donor of "hematopoietic" stem cells - immature cells found in the bone marrow that mature into red blood cells, white blood cells, and platelets. Doctors have traditionally treated children with leukemia using bone marrow donated from a sibling when available, or from an unrelated volunteer donor. Another approach is peripheral blood stem cell (PBSC) transplantation, in which these stem cells are collected from the donor's blood, rather than directly from their bone marrow.

In both types of transplantation, the patient's cancerous bone marrow is destroyed with high doses of chemotherapy or radiation. Then bone marrow or peripheral blood stem cells are given to the patient, which replaces the destroyed marrow.

In adults, peripheral blood collection has become increasingly common in recent years, because it allows donors to avoid the difficulties of bone marrow collection, such as surgery and anesthesia. Since peripheral blood transplantation has been shown to be as safe and effective as bone marrow transplantation in adults, some doctors have begun recommending use of peripheral blood transplants in pediatric patients.

<b>Findings</b>

Eapen and her colleagues compared the outcomes of 143 PBSC and 630 bone marrow transplants in patients with acute leukemia aged 8-20 years who were transplanted between 1995 and 2000. This analysis was performed with data reported to the International Bone Marrow Transplant Registry (IBMTR).

Despite faster recovery of blood counts, more patients who underwent PBSC transplantation died as result of transplant-related complications (26%, compared to 14% of bone marrow transplants) - especially chronic graft-versus-host disease, a potentially serious complication in which the transplanted cells attack the tissues of the recipient. Chronic graft-versus-host disease was significantly higher after PBSC transplants than after bone marrow transplants (33% vs. 19%).

Overall mortality was also higher after PBSC transplants - 57%, versus 44% after bone marrow transplants. The risk of leukemia recurrence after transplantation did not differ. These results persisted after controlling for relevant risk factors that may affect outcomes after transplantation.

It is important to note that the current study addresses transplants from donors only, not "autologous" PBSC transplants, in which stem cells are taken from the patient's own blood. This approach has been proven safe among adults and children, and is widely used.

An accompanying editorial by Donna A. Wall, MD, of the Texas Transplant Institute in San Antonio, underscored the need for a prospective study designed to assess PBSC and bone marrow transplantation in pediatric patients.

"This is an unsettling finding, given that nearly 30% of transplants from sibling donors in pediatric patients now use peripheral blood grafts," Dr. Wall said. "It very well may be that peripheral blood stem cells do not offer a benefit over bone marrow in pediatric patients. It is critical that this question be carefully studied by prospectively identifying the patients, diseases, and clinical settings in which clinical benefit is likely to be observed. Until then, patients and families need to be informed about the risks of transplant-related morbidity, including chronic graft-versus-host disease and higher risk of mortality."

###

"Higher Mortality After Allogeneic Peripheral Blood Transplantation Compared to Bone Marrow in Children and Adolescents." Mary Eapen, et al, International Bone Marrow Transplant Registry, Medical College of Wisconsin, Milwaukee, Wisconsin.

The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world's leading professional society representing physicians who treat people with cancer.


Story Source:

The above story is based on materials provided by American Society Of Clinical Oncology. Note: Materials may be edited for content and length.


Cite This Page:

American Society Of Clinical Oncology. "Blood Transplants May Be More Harmful Than Bone Marrow Transplants In Pediatric Leukemia Patients." ScienceDaily. ScienceDaily, 11 November 2004. <www.sciencedaily.com/releases/2004/11/041104004508.htm>.
American Society Of Clinical Oncology. (2004, November 11). Blood Transplants May Be More Harmful Than Bone Marrow Transplants In Pediatric Leukemia Patients. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2004/11/041104004508.htm
American Society Of Clinical Oncology. "Blood Transplants May Be More Harmful Than Bone Marrow Transplants In Pediatric Leukemia Patients." ScienceDaily. www.sciencedaily.com/releases/2004/11/041104004508.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Quintuplets Head Home

Texas Quintuplets Head Home

Reuters - US Online Video (Aug. 1, 2014) After four months in the hospital, the first quintuplets to be born at Baylor University Medical Center head home. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Ebola Patient Coming to U.S. for Treatment

Ebola Patient Coming to U.S. for Treatment

Reuters - US Online Video (Aug. 1, 2014) A U.S. aid worker infected with Ebola while working in West Africa will be treated in a high security ward at Emory University in Atlanta. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Ebola Vaccine Might Be Coming, But Where's It Been?

Ebola Vaccine Might Be Coming, But Where's It Been?

Newsy (Aug. 1, 2014) Health officials are working to fast-track a vaccine — the West-African Ebola outbreak has killed more than 700. But why didn't we already have one? Video provided by Newsy
Powered by NewsLook.com
Study Links Certain Birth Control Pills To Breast Cancer

Study Links Certain Birth Control Pills To Breast Cancer

Newsy (Aug. 1, 2014) Previous studies have made the link between birth control and breast cancer, but the latest makes the link to high-estrogen oral contraceptives. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins