scholarly journals Comparing Outcomes with Bone Marrow or Peripheral Blood Stem Cells as Graft Source for Matched Sibling Transplants in Severe Aplastic Anemia across Different Economic Regions

2016 ◽  
Vol 22 (5) ◽  
pp. 932-940 ◽  
Author(s):  
Rajat Kumar ◽  
Fumihiko Kimura ◽  
Kwang Woo Ahn ◽  
Zhen-Huan Hu ◽  
Yachiyo Kuwatsuka ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Aplastic Anemia ◽  
Peripheral Blood ◽  
Severe Aplastic Anemia ◽  
Peripheral Blood Stem Cells ◽  
Blood Stem Cells ◽  
Matched Sibling ◽  
Economic Regions

scholarly journals Supplemental peripheral blood stem cells to decrease marrow rejection in adult patients with severe aplastic anemia

2001 ◽  
Vol 69 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Chang-Ki Min ◽  
Dong Wook Kim ◽  
Jong Wook Lee ◽  
Chi Wha Han ◽  
Woo Sung Min ◽  
...  
Keyword(s):  
Stem Cells ◽  
Aplastic Anemia ◽  
Peripheral Blood ◽  
Adult Patients ◽  
Severe Aplastic Anemia ◽  
Peripheral Blood Stem Cells ◽  
Blood Stem Cells

Peripheral Blood Stem Cells vs Bone Marrow for Matched Sibling Transplant in AML and ALL in First Remission.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3321-3321 ◽  
Author(s):  
Mark Kirschbaum ◽  
M. O’Donnell ◽  
R. Spielberger ◽  
R. Bhatia ◽  
V. Pullarkat ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Platelet Count ◽  
Peripheral Blood ◽  
Acute Gvhd ◽  
P Value ◽  
Peripheral Blood Stem Cells ◽  
Significant Difference ◽  
Blood Stem Cells ◽  
Matched Sibling

Abstract We report a retrospective comparison of peripheral blood (PBSC) versus bone marrow derived stem cells for allogeneic transplant in a cohort of similarly treated patients based on eight year data from a single institution. Over the period 1995 to 2003, a total of 151 patients with AML or ALL in first CR underwent allogeneic matched sibling donor transplant, 98 AML patients and 53 with ALL. The source of stem cells was bone marrow in 69, G-CSF mobilized peripheral blood stem cells (PBSC) in 82. Of the AML patients, 40 (58%) received marrow, 58 (71%) received PBSC. Of the ALL patients, 29 (42%) received marrow, 24 (29%) got PBSC. The age of patients receiving marrow was 32.7 ± 13.6, and for those getting PBSC was 36.1 ± 16.1. The conditioning regimen was fully ablative (TBI/VP-16) in all but five patients (Fludarabine/Melphalan in 1 marrow and 4 PBSC pts). GVHD prophylaxis was with cyclosporine/methotrexate in patients receiving ablative conditioning, and CSP/MMF in the flu/mel patients. The time to achieving an ANC >1000 was significantly shorter (P value=.0001) in the PBSC group, 18.2 ±6.6 days vs. 27.2 ±48.7 in the marrow group. Time to achieving a platelet count greater than 25K was significantly shorter (P value=2x10−11) for the PBSC group, 20.9 ± 8.5 vs. 31.8 ± 11.2 for marrow. This was true as well for time to reach platelet counts greater than 100K (P value=10−8), 29.7 ± 28 days for PBSC, 55.8 ±55.6 for marrow. In fact there was a significant increase (P=.0001) in the number of patients, 29 (42%) of marrow recipients vs 11 (13%) of PBSC, who did not at any time achieve a platelet count of >100K. There was no significant difference in survival at 2 years or 4 years between marrow or PBSC-Kaplan-Meier survival probability at 2 and 4 years respectively for AML was.66 and.54 for marrow, and.67 and.54 for PBSC. In ALL, the 2 and 4 year K-M survival probability was.72 and.65 for marrow;.69 and.69 for PBSC recipients. There was no significant difference in acute GVHD, with grade I-II described in 19 (28%) of the marrow pts, 29 (35%) in the PBSC pts, and grade II-IV in 8 (12%) marrow pts and 11 (13%) receiving PBSC (p value =.57), or chronic GVHD (P value=.62). Interestingly, in a subset analysis of patients who were diagnosed with acute GVHD, there was a significant difference in disease free survival at 5 years (see graph), suggesting that there is a qualitative difference between acute GVHD observed as a result of bone marrow versus PBSC as a source of stem cells. Figure Figure

scholarly journals Co-transplantation of umbilical cord mesenchymal stem cells and peripheral blood stem cells in children and adolescents with refractory severe aplastic anemia

2021 ◽  
Author(s):  
fangfang Yuan ◽  
MingYue Zhao ◽  
Nan Ma ◽  
Shanggang Zong ◽  
Gangping Li ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Aplastic Anemia ◽  
Children And Adolescents ◽  
Umbilical Cord ◽  
Peripheral Blood ◽  
Severe Aplastic Anemia ◽  
Donor Group ◽  
Peripheral Blood Stem Cells ◽  
Blood Stem Cells

Objectives: The purpose of our study was to analyze the co-transplantation efficacy of umbilical cord mesenchymal stem cells (UC-MSCs) and peripheral blood stem cells (PBSCs), which is considered as a novel approach for refractory severe aplastic anemia (RSAA) in children and adolescents. Methods: Thirty-two children and adolescents with RSAA were retrospectively reviewed. According to the source of PBSCs, all patients were divided into two groups (matched sibling donor group and matched unrelated donor group). Engraftment, graft-versus-host disease (GVHD) and overall survival (OS) were analyzed. Results: No adverse events related to UC-MSCs infusion occurred in all patients. The median time for neutrophil engraftment was 13 (10~23) days and 15 (11~28) days for platelet. Grade Ⅰ ~ Ⅱ acute GVHD and moderate chronic GVHD were observed in 21.88% and 12.50% of the cases. No statistically significance was observed between the MSD and MUD group on engraftment, GVHD and complications including infection and hemorrhagic cystitis. The median follow-up time was 38.60 (1.37~140.83) months. To the date of October 31th 2021, 5 died and 27 (84.38%) survived. The 5-year OS rate was not statistically significant between the MSD and MUD group (84.8% ± 10.0% vs 82.4% ± 9.2%, P = 0.674). Conclusions: The application of UC-MSCs in the treatment of RSAA in PBSC transplantation is reliable and safe, which can significantly reduce the incidence of GVHD and severe transplantation-related complications and effectively improve patients’ life quality. Therefore, the method can be used as an active treatment option for patients with RSAA.

Cytokine-Mediated Expansion of 5-FU Resistant Peripheral Blood Stem Cells and Bone Marrow: Self-Renewal and Commitment Capacity*

1994 ◽  
Vol 3 (2) ◽  
pp. 135-139
Author(s):  
ALISON RICE ◽  
JEAN-MICHEL BOIRON ◽  
CAROLINE BARBOT ◽  
MARYSE DUPOUY ◽  
NADINE DUBSOC-MARCHENAY ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cells ◽  
Self Renewal ◽  
Blood Stem Cells

Fludarabine Based Conditioning for Allogeneic Transplantation in Severe Aplastic Anemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2029-2029
Author(s):  
Mammen Chandy ◽  
Biju George ◽  
Auro Viswabandya ◽  
Vikram Mathews ◽  
Ashish Bajel ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Allogeneic Transplantation ◽  
Severe Aplastic Anemia ◽  
Peripheral Blood Stem Cells ◽  
Allogeneic Bmt ◽  
Gvhd Prophylaxis ◽  
Blood Stem Cells

Abstract Patients with severe aplastic anemia (SAA) who are multiply transfused or septic have a poor outcome after allogeneic stem cell transplantation. Forty three patients (31 males and 12 females) with SAA underwent allogeneic BMT using a fludarabine based conditioning regimen between 1998 and 2005. The median age was 20 years (range: 4–38) with 11 children and 32 adults. All donors were 6 antigen matched HLA identical sibling or family donors. Co morbidities seen included bacterial sepsis in 15 patients, fungal pneumonia in 4 and a recent intracranial bleed in 5 patients. Seven patients had failed Antithymocyte or antilymphocyte globulin (ATG/ALG) and two patients had failed their first transplant. The median time from diagnosis to transplant was 12 months (range: 2 – 96) and the median transfusions prior to BMT was 28 (range: 2 – 380). Conditioning therapy consisted of: Fludarabine (Flu) 180 mg/m2 over 6d + Busulfan (Bu) 8 mg/kg over 2d + ATG 40 mg/kg/day over 4 d in 17 patients, Flu 180 mg/m2 over 6d + Cyclophosphamide (Cy) 120 mg/kg over 2d ± ATG 40 mg/kg/day over 4d in 17 patients, Flu/TBI/OKT3 in 4, and Cy 120 + Flu 150mg/m2 in 5 patients. Graft versus host disease (GVHD) prophylaxis consisted of Cyclosporine and mini methotrexate. Graft source was peripheral blood stem cells in 39 patients and G-CSF stimulated bone marrow in 4. The median cell dose was 5.2 x 108 MNC/kg (range: 2.1 – 13.6) for PBSC and 5.2 x 108 TNC/kg (range: 3.7 – 6.8) for bone marrow. Five patients expired within the first 10 days due to sepsis. Thirty seven patients engrafted with a mean time to ANC > 500 of 11.6 days (range: 8 – 18) and median platelet engraftment time of 13 days (range: 8 – 32). One patient had primary graft failure and expired on day 64 due to fungal pneumonia despite a second transplant. Acute GVHD was seen in 14 patients (38%) with Grade III–IV GVHD in 4 (10.5%). Chronic GVHD was seen in 10 patients with 6 having limited and 4 with extensive GVHD. Two patients had secondary graft rejection on day + 24 and +60 respectively and expired due to fungal pneumonia. At a median follow up of 17 months (range: 5 – 78); 29 patients (67.7%) are alive and well. Among patients treated with Flu/Bu/ATG, 12/17 (70.5%) are alive and well while the DFS is 82% (14/17) in patients treated with Flu/Cy ± ATG. Comparison with patients conditioned with Cy/ATG during 1990–2004 is given in the table. This comparison suggests that a fludarabine based conditioning regimen may be better, with less rejection, than Cy/ATG for allogeneic BMT in sick patients with SAA who are infected and multiply transfused at the time of BMT. Comparative data Fludarabine Cy/ATG Number 43 26 Rejection 3 (7%) 7 (27%) DFS 29(67.7%) 11 (46%)

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