Transplant With Unrelated Donor Bone Marrow Associated With Better Patient-Reported Outcomes Than Peripheral Blood

Patients who underwent hematopoietic cell transplantation (HCT) with bone marrow (BM) from unrelated donors reported better five-year outcomes than those who received peripheral blood, according to a study published in JAMA Oncology.

Stephanie J. Lee, MD, MPH, of the Clinical Research Division at Fred Hutchinson Cancer Research Center in Seattle, Washington, and authors led this follow-up of a large, multicenter, randomized clinical trial that included 551 patients ≥16 years old with hematologic neoplasms who received unrelated donor BM or peripheral blood.

At five years after HCT, 102 BM and 93 peripheral blood patients were alive and eligible for assessment. BM recipients fared significantly better on Mental Health Inventory Psychological Well-Being scores (78.9 vs. 72.2; p=0.01; in which higher score was better) and chronic graft-versus-host disease (GVHD) symptom scores (13.1 vs. 19.3; p=0.004; in which lower score was better) compared with those receiving peripheral blood.

In addition, 71 percent of patients in the BM group (n=72) had no chronic GVHD at five years compared with 49 percent of patients in the peripheral blood cohort (n=46). BM was also associated with better functional well-being (p=0.02), higher health rating scale scores (p=0.02), and perceptions of overall quality of life (p=0.04). Recipients of BM were also more likely to be working full- or part-time (odds ratio = 1.5; 95% CI 1.2-2.0; p=0.002).

After a median follow-up of 73 months (range = 30-121 months), no differences in survival (40% vs. 39%; p=0.84), relapse (32% vs. 29%; p=0.47), or treatment-related mortality (29% vs. 32%; p=.44) were identified.

“Bone marrow should be the standard of care for these types of transplant procedures,” the authors concluded.

Source: Lee SJ, Logan B, Westervelt P, et al. Comparison of patient-reported outcomes in 5-year survivors who received bone marrow vs peripheral blood unrelated donor transplantation: Long-term follow-up of a randomized clinical trial. JAMA Oncol. 2016 August 11. [Epub ahead of print]