COMPARABLE OUTCOMES OF ALLOGENEIC PERIPHERAL BLOOD VERSUS BONE MARROW HEMATOPOIETIC STEM CELL TRANSPLANTATION IN CHILDREN

Abstract

Objective: Hematopoietic stem cell transplantation (HSCT) is used in many malignant and non-malignant diseases in pediatric patients. Peripheral blood (PB), bone marrow (BM) or cord blood can be used as a graft source. In this study, it was aimed to compare the transplantation results of patients who used bone marrow as a graft source and those who used peripheral blood in pediatric patients who underwent allogeneic HSCT. Methodology: We retrospectively analyzed the transplant results of 349 pediatric patients who received a transplant between April 2010 and August 2021 considering their stem cell source as a comparative variable. Engraftment days, development of acute graft versus host disease(aGVHD) or chronic graft versus host disease (cGVHD), development of relapse and overall survival of patients were evaluated. The source of stem cells was BM in 240 and PB in 109 patients. Results: The mean age of patients was 96.8±60 and 94.5±63 months in BM and PB group, respectively. The mean myeloid and platelet engraftment time was statistically significantly earlier in PB group (p<0.001). Acute GVHD was statistically significantly higher in PB group (p<0.001). The relapse rate was statistically significantly higher in the PB group (p:0.02). The mean follow-up period was 49.2±41.6 months. The 5-year overall survival rate was 83.4% in the BM group and 68.5% in the PB group (p:0.003). Conclusion: In our study, in accordance with the literature, it was observed that myeloid and platelet engraftment was earlier if the source is PB in HSCT in pediatric patients, but acute GVHD was more frequent. In the survival analysis, the 5-year survival of the bone marrow transplant group was found to be higher. Peripheral blood could be an alternative stem cell source in patients but it would be more appropriate to decide the stem cell source according to the primary diagnosis of the patients.