Impact of stem cell selection between bone marrow and peripheral blood stem cells for unrelated hematopoietic stem cell transplantation for hematologic malignancies: on behalf of the Donor/Source Working Group of the Japanese Society for Transplantation and Cellular Therapy

Hiromi Hayashi; Makoto Iwasaki; Hideki Nakasone; Reo Tanoshima; Masashi Shimabukuro; Wataru Takeda; Tetsuya Nishida; Shinichi Kako; Shin-Ichiro Fujiwara; Yuta Katayama; Masashi Sawa; Kentaro Serizawa; Ken-Ichi Matsuoka; Naoyuki Uchida; Takashi Ikeda; Hiroyuki Ohigashi; Kentaro Fukushima; Moeko Hino; Yoshinobu Kanda; Takahiro Fukuda; Yoshiko Atsuta; Junya Kanda

doi:10.1016/j.jcyt.2023.11.012

Impact of stem cell selection between bone marrow and peripheral blood stem cells for unrelated hematopoietic stem cell transplantation for hematologic malignancies: on behalf of the Donor/Source Working Group of the Japanese Society for Transplantation and Cellular Therapy

Cytotherapy. 2024 Feb;26(2):178-184. doi: 10.1016/j.jcyt.2023.11.012. Epub 2023 Dec 16.

Authors

Hiromi Hayashi¹, Makoto Iwasaki¹, Hideki Nakasone², Reo Tanoshima³, Masashi Shimabukuro⁴, Wataru Takeda⁵, Tetsuya Nishida⁶, Shinichi Kako⁷, Shin-Ichiro Fujiwara⁸, Yuta Katayama⁹, Masashi Sawa¹⁰, Kentaro Serizawa¹¹, Ken-Ichi Matsuoka¹², Naoyuki Uchida¹³, Takashi Ikeda¹⁴, Hiroyuki Ohigashi¹⁵, Kentaro Fukushima¹⁶, Moeko Hino¹⁷, Yoshinobu Kanda¹⁸, Takahiro Fukuda⁵, Yoshiko Atsuta¹⁹, Junya Kanda²⁰

Affiliations

¹ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
² Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan.
³ YCU Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Yokohama, Japan.
⁴ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
⁵ Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
⁶ Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.
⁷ Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
⁸ Division of Hematology, Jichi Medical University, Shimotsuke, Japan.
⁹ Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan.
¹⁰ Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
¹¹ Division of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Hospital, Osakasayama, Japan.
¹² Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan.
¹³ Department of Hematology, Federation of National Public Service Personnel Mutual Aid Association Toranomon Hospital, Tokyo, Japan.
¹⁴ Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan.
¹⁵ Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
¹⁶ Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
¹⁷ Department of Pediatrics, School of Medicine, Chiba University, Chiba, Japan.
¹⁸ Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Hematology, Jichi Medical University, Shimotsuke, Japan.
¹⁹ Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan.
²⁰ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: [email protected].

PMID: 38108686
DOI: 10.1016/j.jcyt.2023.11.012

Abstract

Background aims: This study aimed to comprehensively assess the impact of stem cell selection between bone marrow (BM) and peripheral blood (PB) in unrelated hematopoietic stem cell transplantation (HSCT) for hematological malignancies. Our objective was to identify specific factors associated with better transplant outcomes.

Methods: A retrospective analysis was conducted using data from the Japanese HSCT registry. Inclusion criteria were patients aged 0-70 years who underwent their first unrelated HSCT with BM or PB, with an 8/8 or 7/8 allele HLA match for hematological malignancies between 2010 and 2020.

Results: Among 10 295 patients, no significant difference was observed in overall survival, relapse, graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) or non-relapse mortality between the groups. Patients who received PB showed no clear difference in acute GVHD but had a greater rate of chronic GVHD, resulting in poor chronic GVHD-free, relapse-free survival (CRFS). Subgroup analyses highlighted the importance of patient-specific factors in source selection. Patients with non-Hodgkin lymphoma and a greater hematopoietic cell transplantation-comorbidity index showed better CRFS and GRFS when BM was the preferred source. Similar trends were observed among patients with standard-risk disease for CRFS. However, no such trends were evident among patients aged 0-24 years, indicating that both sources are viable choices for young patients.

Conclusions: This real-world retrospective analysis showed similar basic outcomes for BM and PB in an unrelated setting. The results support that BM may still be preferred over PB, especially when the long-term quality of life is a major concern. A consideration of individual factors can further optimize transplant success. Further research is warranted to explore the long-term implications of stem cell source selection.

Keywords: bone marrow; graft-versus-host disease; peripheral blood stem cells; quality of life.

Publication types

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

MeSH terms

Bone Marrow
Bone Marrow Transplantation / methods
Graft vs Host Disease* / etiology
Graft vs Host Disease* / therapy
Hematologic Neoplasms* / therapy
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Japan
Neoplasm Recurrence, Local / etiology
Peripheral Blood Stem Cell Transplantation* / methods
Peripheral Blood Stem Cells*
Quality of Life
Retrospective Studies