Dr. Anasetti Discusses the Trade-offs of BMT and PBSC

Claudio Anasetti, MD, chair, Department of Blood and Marrow Transplant, H. Lee Moffitt Cancer Center and Research Institute, the lead author of the phase III, prospective, randomized, multicenter trial, which examined the differences between bone marrow transplant (BMT) and peripheral blood stem cell (PBSC) transplant from unrelated donors.

The trial found that PBSC transplants increased the rates of graft-versus-host disease (GVHD) when compared to BMT. The trial did not find a significant difference in mortality rates between the two arms.

While the mortality rates were similar the causes varied. BMT resulted in 8% more deaths related to graft failure. These deaths were complex and the result of an infection that often lasted for several months. In comparison, PBSC put the patient at a 16% higher risk of developing chronic extensive GVHD, which can last for multiple years after the transplant.

Since the mortality rates were similar and PBSC transplant was shown to increase the rate of chronic extensive GVHD Anasetti believes this trial will result in a decreased use of PBSC transplant in the future.

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