(January 29, 2010 - Insidermedicine)

Ten years after treatment, individuals with leukemia treated with peripheral stem cell transplantation are doing about as well as those who received a bone marrow transplant, according a long-term update of a randomized trial published online ahead of print in The Lancet Oncology.

Here is some information about leukemia and its treatment:

•    It is a cancer of the bone marrow and blood that has both acute and chronic forms

•    One of the many treatments for leukemia is allogeneic stem cell transplantation, in which the patient’s cells that make blood and immune cells are killed off with chemotherapy and replaced with new ones

•    These new stem cells can be obtained from the bone marrow of a donor, called a bone marrow transplant, or they can be obtained from the blood of a donor, called peripheral stem cell transplant.

Researchers representing The European Group for Blood and Marrow Transplantation (EBMT) compared the 10-year outcomes of 329 leukemia patients who had been randomly assigned to treatment with a bone marrow transplant or a peripheral stem cell transplant in the years 1995 to 1999. Most of those who lived more than 3 years completed questionnaires about their health and the long-term effects of their treatment.

Overall 10-year survival rates were similar for both groups, with a survival rate of 49% among those who were treated with peripheral blood and 56% for those who were treated with bone marrow. Patients with acute forms of leukemia, however, tended to live longer without a recurrence of their leukemia if they were treated with a bone marrow transplant. Patients treated with peripheral blood cells were more likely to have ongoing immune system-related complications from treatment and to require immune system suppressing drugs for 5 or more years, but there was no difference between the two groups with respect to their overall ability to function, return to work, incidence of serious lung complications, blood functioning, or incidence of secondary cancers.

Today’s research demonstrates that, overall, individuals with leukemia can expect similar long-term results from bone marrow and peripheral blood stem cell transplantations. However, there is some suggestion that certain subgroups of patients may be better off with bone marrow transplant.