Peripheral Blood: An Alternative Source of Stem Cells in Thalassemia

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Accessing peripheral blood as a graft source is easier and less invasive than accessing bone marrow.
Accessing peripheral blood as a graft source is easier and less invasive than accessing bone marrow.

Peripheral blood could serve as an alternative source of stem cells for patients with transfusion-dependent thalassemia, according to recent results published in Biology of Blood and Marrow Transplantation.

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only available curative treatment for transfusion-dependent thalassemia, but accessing bone marrow as a graft source is invasive and inconvenient. Peripheral blood is more easily accessed. 

Researchers assessed transplant results from 567 patients with transfusion-dependent thalassemia who underwent transplant in Iran between 1998 and 2015. They used transplant source (peripheral blood vs bone marrow) as a comparative variable.

Most patients (75%; 425/567) underwent transplant with peripheral blood as the graft source, and the remainder (25%; 142/567) underwent transplant with bone marrow as the graft source. The median follow-up was 6.5 years for both groups and 15-year overall survival (OS) was 74.57% (95% CI, 70.41% - 78.24%).

OS and thalassemia-free survival at 2, 5, and 15 years were not significantly different between the peripheral blood and bone marrow groups. However, rejection incidence was significantly lower in the peripheral blood group compared with the bone marrow group at 2-, 5-, and 15-year time points. At all 3 time points, the rejection incidence was just under 6% in the peripheral blood group compared with approximately 18% in the bone marrow group (P <.0001).

Nonetheless, acute and chronic graft-versus-host disease were more prevalent in the peripheral blood group.

With a lower rejection incidence rate and greater convenience, peripheral blood could serve as a less invasive alternative source of stem cells for patients with transfusion-dependent thalassemia.

Reference

1. Ghavamzadeh A, Kasaeian A, Rostami T, Kiumarsi A. Comparable outcomes of allogeneic peripheral blood versus bone marrow hematopoietic stem cell transplantation in major thalassemia: a multivariate long-term cohort analysis [published online September 26, 2018]. Biol Blood Marrow Transplant. doi: 10.1016/j.bbmt.2018.09.026

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