Blood Cancer

Transplants of special cells in the blood stream may be more effective than bone marrow transplants in patients who receive high-dose chemotherapy for blood cancer, according to a large randomized trial reported in the New England Journal of Medicine on January 18, 2001.


Physicians use both kinds of transplants in blood cancers such as leukemia and lymphoma, primarily to restore bone marrow destroyed by high-dose chemotherapy. In this study, the transplanted cells from the blood stream - known as peripheral blood cells -- took effect more quickly than the marrow transplants, without increasing the risk of complications.


Led by William Bensinger, M.D., at the Fred Hutchinson Cancer Research Center in Seattle, Wash., the researchers compared the two kinds of transplants in 172 patients from between 12 and 55 years of age. Patients were randomly assigned to two groups, one to receive the marrow transplants and the other to received the peripheral blood cells. Both transplants were allogeneic -- came from relatives -- and were given after high doses of chemotherapy with or without radiation therapy.


The patients in the trial who received peripheral blood cells recovered from the effects of the high-dose chemotherapy more quickly than those who received bone marrow transplants. Their blood counts -- the numbers of white blood cells and platelets -- returned to normal levels five or six days faster and they required fewer transfusions of platelets.