Is peripheral blood or bone marrow a better source of stem cells for transplantation in cases of HLA-matched unrelated donors? A meta-analysis

Background: Peripheral-blood (PB) and bone marrow (BM) are both widely used in hematopoietic stem cell transplantation (HSCT). However, it has been controversial whether the use of PB or BM leads to a more favorable outcome of HSCT that involves unrelated HLA-matched donors. Methods: We searched PubMed and Medline for relevant articles. Risk ratio (RR) and 95% confidence intervals (CIs) were calculated for statistical analyses. Results: Twelve studies and 5589 patients were included in the assessment. The rate of engraftment (both neutrophil and platelet) was higher in the PBSCT group (RR = 1.02, 95% CI = 1.01-1.03, P=0.009; RR = 1.18, 95% CI = 1.00-1.41, P = 0.05, RR = 1.025, 95% CI = 1.010-1.039, P = 0.000; RR = 1.031,95% CI = 1.012-1.051, P = 0.002). In subgroup analyses, chronic GVHD and transplantation-related mortality were probably influenced by basic disease, conditioning. No significant statistical differences were found on the rate of relapse, 2-year overall survival (OS) and disease-free survival (DFS) after peripheral blood stem cell neither bone marrow transplantation (PBSCT and BMT). Conclusion: PBSC as a graft source shown more complete engraftment of neutrophil and platelet, but the decision to use either peripheral blood or bone marrow was made depended on the diagnosis, the conditioning regimen and the transplantation protocols. (C) 2015 Published by Elsevier Ireland Ltd.