Peripheral and Marrow Grafts in Leukemia Compared

Study is the first to compare relapse rates in acute myelocytic leukemia by source of autograft

THURSDAY, July 16 (HealthDay News) -- For patients in remission with acute myelocytic leukemia, the risk of relapse is higher and the prospect of leukemia-free survival is lower for patients who undergo autologous stem cell transplantation from peripheral blood versus bone marrow, according to a study published online July 13 in the Journal of Clinical Oncology.

Norbert-Claude Gorin, M.D., of Hopital Saint Antoine in Paris, and colleagues analyzed data on 2,165 acute myelocytic leukemia patients in remission, who underwent autologous stem cell transplantation between 1994 and 2006, including 1,607 who received peripheral blood autografts and 558 who received bone marrow autografts. Relapse incidence and leukemia-free survival were compared for three groups: those with peripheral blood transplantation early after remission (≤80 days), late (>80 days), or those with bone marrow transplantation.

Using multivariate analysis, the researchers found that relapse was higher with autografts from peripheral blood performed early (56 percent; hazard ratio, 1.45) or later (46 percent; hazard ratio, 1.3) than with autografts from bone marrow (39 percent). This resulted in poorer leukemia-free survival for the peripheral blood groups: 36 percent for early transplantation, 46 percent for late transplantation, and 52 percent for bone marrow transplantation.

"The results of this study confirm observations from several centers of occasional, unexpected, early and massive relapses with peripheral blood transplants and a higher overall relapse incidence with peripheral blood than with bone marrow," the authors conclude.

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