Hematopoietic stem cell transplantation has been consolidated in recent years as a good alternative to traditional bone marrow transplantation. This method allows cells in the bloodstream of a compatible donor, able to repopulate the bone marrow of a patient with leukemia, more simply and without anesthesia. A study published in the journal ‘The Lancet’ after 10 years of follow clarifies some of the doubts that might still be on their use.
For hematopoietic progenitor cells (blood stem cells able to repopulate the bone) ‘enough’ to refer to the donor pre-treatment to multiply the presence of these units in their blood and then extract and implant in a patient with leukemia or other haematological malignancies.
As explained by Dr. Javier Lopez, a hematologist at the Hospital Ramón y Cajal de Madrid, the peripheral blood has an advantage over bone marrow, which is that “offers a faster recovery,” because it takes less time to ‘catch’. So, now usually opt for this technique to treat patients with advanced leukemia, to ensure that your bone marrow recover quickly. While in patients with less advanced disease, is chosen by the bone marrow, which takes a few more days at work in exchange for offering a better safety profile.
In order to clarify the differences between the two methods in the long term, the European Group for Blood and Marrow Transplantation (from Germany led by Dr. Birte Freidrichs) has compared the evolution of 329 patients with various types of leukemia treated both transplants across Europe between 1995 and 1999.
After a median follow-up 10 years (the most extensive to date), the researchers found no difference in the prognosis of survival with bone marrow or peripheral blood (donated by both brothers supported.) In fact, they add, although patients treated with this technique were more complications of rejection (the so-called graft versus host disease), this problem did not result in more deaths.
In patients with acute leukemia, there was a trend of survival better (although not statistically significant) in bone marrow transplant with peripheral blood. Only in chronic myeloid leukemia were more positive results with peripheral blood. “These findings suggest that there is a subgroup of patients who may benefit even bone marrow transplantation.”
“After a decade of monitoring, increased incidence of graft-versus-host disease did not result in a greater number of deaths, nor affected the overall health of patients, nor their social integration, complete these European hematologists . In his view, the results do not allow to conclude for themselves that it is time to return to bone marrow transplants for certain indications, but that this technique can not be parked entirely at the moment.