Is peripheral blood or bone marrow a better source of stem cells for transplantation in cases of HLA-matched unrelated donors? A meta-analysis

Sha Wu; Cheng Zhang; Xi Zhang; Ya-qi Xu; Tian-xia Deng

doi:10.1016/j.critrevonc.2015.04.009

Is peripheral blood or bone marrow a better source of stem cells for transplantation in cases of HLA-matched unrelated donors? A meta-analysis

Crit Rev Oncol Hematol. 2015 Oct;96(1):20-33. doi: 10.1016/j.critrevonc.2015.04.009. Epub 2015 May 13.

Authors

Sha Wu¹, Cheng Zhang¹, Xi Zhang², Ya-qi Xu¹, Tian-xia Deng¹

Affiliations

¹ Department of Hematology, Xinqiao Hospital, Third Military Medical University, Gaotantyan Street, Chongqing 400037, China.
² Department of Hematology, Xinqiao Hospital, Third Military Medical University, Gaotantyan Street, Chongqing 400037, China. Electronic address: zhangxxi@sina.com.

PMID: 26095619
DOI: 10.1016/j.critrevonc.2015.04.009

Abstract

Background: Peripheral-blood (PB) and bone marrow (BM) are both widely used in hematopoietic stem cell transplantation (HSCT). However, it has been controversial whether the use of PB or BM leads to a more favorable outcome of HSCT that involves unrelated HLA-matched donors.

Methods: We searched PubMed and Medline for relevant articles. Risk ratio (RR) and 95% confidence intervals (CIs) were calculated for statistical analyses.

Results: Twelve studies and 5589 patients were included in the assessment. The rate of engraftment (both neutrophil and platelet) was higher in the PBSCT group (RR=1.02, 95% CI=1.01-1.03, P=0.009; RR=1.18, 95% CI=1.00-1.41, P=0.05, RR=1.025, 95% CI=1.010-1.039, P=0.000; RR=1.031, 95% CI=1.012-1.051, P=0.002). In subgroup analyses, chronic GVHD and transplantation-related mortality were probably influenced by basic disease, conditioning. No significant statistical differences were found on the rate of relapse, 2-year overall survival (OS) and disease-free survival (DFS) after peripheral blood stem cell neither bone marrow transplantation (PBSCT and BMT).

Conclusion: PBSC as a graft source shown more complete engraftment of neutrophil and platelet, but the decision to use either peripheral blood or bone marrow was made depended on the diagnosis, the conditioning regimen and the transplantation protocols.

Keywords: Bone marrow; Hematopoietic stem cell transplantation; Peripheral blood.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Bone Marrow Transplantation*
Hematopoietic Stem Cell Transplantation*
Histocompatibility Testing*
Humans
Peripheral Blood Stem Cell Transplantation*
Transplantation Conditioning
Unrelated Donors*