Mobilized peripheral blood stem cells (PBSC) have been widely used instead of bone marrow (BM) as the graft source for allogeneic hematopoietic cell transplantation (HCT). Although early studies demonstrated no significant differences in survival between PBSC transplantation (PBSCT) and BM transplantation (BMT) from human leukocyte antigen (HLA)-identical sibling donors to adults with hematological malignancies, recent results have been unclear. The objective of this retrospective study was to compare overall survival (OS), relapse, non-relapse mortality (NRM), hematopoietic recovery and graft-versus-host disease (GVHD) between PBSCT and BMT according to the time period of HCT (2003–2008, 2009–2014, or 2015–2020). We retrospectively compared the outcomes after PBSCT versus BMT in 6064 adults with hematological malignancies using a Japanese registry database between 2003 and 2020. The adjusted probability of OS was significantly higher in BMT recipients compared to PBSCT recipients during the early period of 2003–2008 (adjusted hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.70–0.91; < 0.001) and the middle period of 2009–2014 (adjusted HR, 0.80; 95% CI, 0.70–0.91; < 0.001). However, during the late period of 2015–2020, the adjusted probability of OS was comparable between BMT and PBSCT recipients (adjusted HR, 0.94; 95% CI, 0.79–1.13; = 0.564), which were mainly due to the reduction of NRM. There was no significant difference in the relapse rate between the groups, irrespective of the time period. Compared to BMT, PBSCT led to faster neutrophil and platelet recovery and the cumulative incidences of grades II–IV and grades III–IV acute and overall and extensive chronic GVHD were significantly higher in PBSCT recipients, irrespective of the time period. PBSCT and BMT had similar survival outcomes and relapse rates in adult patients with hematological malignancies during the late time period of 2015–2020 despite the hematopoietic recovery and acute and chronic GVHD being higher in PBSCT recipients in all time periods.

中文翻译：

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2003 年至 2020 年，对 6064 名成人进行同种异体骨髓移植与来自 HLA 相同同胞供体的外周血干细胞治疗血液系统恶性肿瘤：不同时间段对生存的不同影响

动员外周血干细胞（PBSC）已广泛用于代替骨髓（BM）作为同种异体造血细胞移植（HCT）的移植来源。尽管早期研究表明，人类白细胞抗原 (HLA) 相同的同胞供体的 PBSC 移植 (PBSCT) 和 BM 移植 (BMT) 与患有血液恶性肿瘤的成人的生存率没有显着差异，但最近的结果尚不清楚。这项回顾性研究的目的是根据 HCT 的时间段（2003 年）比较 PBSCT 和 BMT 的总生存期（OS）、复发、非复发死亡率（NRM）、造血恢复和移植物抗宿主病（GVHD） –2008 年、2009–2014 年或 2015–2020 年）。我们使用日本登记数据库，回顾性比较了 2003 年至 2020 年间 6064 名患有血液恶性肿瘤的成人接受 PBSCT 与 BMT 后的结果。与 2003 年至 2008 年间的 PBSCT 接受者相比，BMT 接受者的调整后 OS 概率显着更高（调整后的 OS 概率显着高于 PBSCT 接受者）。风险比 [HR]，0.79；95% 置信区间 [CI]，0.70-0.91；< 0.001）和 2009-2014 年中期（调整后的 HR，0.80；95% CI，0.70-0.91；< 0.001）。然而，在2015-2020年后期，BMT和PBSCT接受者之间调整后的OS概率相当（调整后HR，0.94；95% CI，0.79-1.13；= 0.564），这主要是由于NRM的降低。无论时间段如何，各组之间的复发率没有显着差异。与 BMT 相比，PBSCT 导致中性粒细胞和血小板恢复更快，并且无论时间段如何，PBSCT 接受者中 II-IV 级和 III-IV 级急性以及总体和广泛慢性 GVHD 的累积发生率均显着更高。 2015-2020年后期，尽管PBSCT接受者的造血恢复以及急性和慢性GVHD在所有时间段内都较高，但PBSCT和BMT在患有血液恶性肿瘤的成年患者中具有相似的生存结果和复发率。