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Blood transplants may be more harmful than bone marrow transplants 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."

Background

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 pe
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Contact: Danielle Potuto
potutod@asco.org
703-519-1422
American Society of Clinical Oncology
1-Nov-2004


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