Survival among people with leukemia who receive bone marrow transplants is the same as those who have a type of stem cell transplant with a higher risk of rejection, a 10-year study suggests.

Unlike bone marrow transplants that collect stem cells, peripheral blood stem cell transplantation (PBSCT) involves collecting stem cells from the donor's blood. This avoids the need for surgery and anesthesia that are part of bone marrow collection.

Dr. Birte Friedrichs of Asklepios Hospital St Georg in Hamburg, Germany, and his colleagues compared survival rates in 329 patients in Europe, Israel and Australia who were randomly assigned to receive either bone marrow transplants or PBSCT. Participants survived for an average of 9.3 years after the transplants.

Overall, the 10-year survival was 49.1 per cent among the 84 who had PBSCT and 56.5 per cent for the bone marrow transplants, the team reported in Monday's online issue of the Lancet Oncology.

"This update comparing two important stem cell sources did not find differences in survival after 10-year followup," the study's authors concluded.

The researchers also found a trend towards improved survival after bone marrow transplants in people with acute leukemias, but it was not statistically significant.

The 10-year survival rates were:

  • Acute myeloid leukemia (AML): 62.3 per cent for bone marrow and 47.1 per cent for PBSCT transplants.
  • Acute lymphoblastic leukemia: 28.3 per cent in the bone marrow transplant group compared with 13 per cent in the PBSCT transplant group.
  • Chronic myeloid leukemia: 40.2 per cent for bone marrow transplant and 48.5 per cent for PBSCT transplant.

"Our observations support previous reports that different patient groups might still benefit from transplantation with bone marrow," the researchers wrote.

Chronic graft versus host disease, a type of rejection, was more common among PBSC transplant patients (73 per cent) than among bone marrow transplant patients (54 per cent), and more stem cell recipients needed immunosuppressive treatment five years after transplantation, but it did not affect their general health or ability to return to work.