The haematopoietic stem cell transplantation has been consolidated in recent years as a good alternative to traditional bone marrow transplantation. This method allows cells in the bloodstream of a compatible donor, able to repopulate the bone marrow of a patient with leukemia, more simply and without anesthesia. A study published in the journal ‘The Lancet’ after 10 years of follow clarifies some of the doubts that still could be on its use.
For hematopoietic progenitors (blood stem cells able to repopulate the marrow) ‘enough’ to refer to the donor pretreatment to multiply the presence of these units in their blood and then extracting and implanting them in a patient with leukemia or other haematological malignancies.As explained by Dr. Javier López, a hematologist at the Hospital Ramon y Cajal in Madrid, the peripheral blood has an advantage over bone marrow, which is “offers a faster recovery,” because it takes less time to ‘catch’. So, now usually opt for this technique to treat patients with advanced leukemias, to ensure that your bone marrow recover quickly. While in patients with less advanced disease, it chooses the bone marrow, which takes a few more days at work in exchange for offering a better safety profile.
To clarify the difference between the two methods in the long term, the European Group for Blood and Marrow Transplantation (from Germany led by Dr. Birte Freidrichs) compared the evolution of 329 patients with various types of leukemia treated with both transplants across Europe between 1995 and 1999.
After an average of 10 years of follow up (the largest to date), the researchers observed no difference in the prognosis of survival with bone marrow or peripheral blood (donated by both brothers supported). In fact, they add, although patients treated with this latter technique were more complications of rejection (so-called graft versus host disease), this problem has not translated into higher number of deaths.
In patients with acute leukemia, there was a trend of better survival (although not statistically significant) in bone marrow transplant with peripheral blood. Only in chronic myeloid leukemia were more positive results with peripheral blood. “These findings suggest that a subgroup of patients who can benefit even bone marrow transplantation.
“After a decade of monitoring, the higher incidence of graft versus host disease did not result in a greater number of deaths, nor affected the overall health of patients, nor to their social integration”, European hematologists complete these . In his view, the results do not allow to conclude for themselves that it is time to re-marrow transplants for certain indications, but the technique can not be parked entirely at the moment.
Tags: peripheral blood, transplantation
