***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Prospect i ve studies have shown rapid engraftment using granulocyte-colony-stimulating factor-mobilized peripheral blood stem cells ( G-PBSCs ) for allogeneic transplantation , though the risks for graft-versus-host disease ( GVHD ) may be increased . It was hypothesized that the use of G-CSF to prime bone marrow ( G-BM ) would allow rapid engraftment without increased risk for GVHD compared with G-PBSC .  Patients were r and omized to receive G-BM or G-PBSCs for allogeneic stem cell transplantation . The study was design ed ( beta < .8 ) to detect a difference in the incidence of chronic GVHD of 33 % ( alpha < .05 ) . The plan was to recruit 100 patients and to conduct an interim analysis when the 6-month follow-up point was reached for the first 50 patients . Fifty-seven consecutive patients were recruited ( G-BM , n = 28 ; G-PBSC , n = 29 ) . Patients in the G-PBSC group received 3-fold more CD34(+ ) and 9-fold more CD3(+ ) cells . Median times to neutrophil ( G-BM , 16 days ; G-PBSC , 14 days ; P < .1 ) and platelet engraftment ( G-BM , 14 days ; G-PBSC , 12 days ; P < .1 ) were similar . The use of G-PBSC was associated with steroid refractory acute GVHD ( G-BM , 0 % ; G-PBSC , 32 % ; P < .001 ) , chronic GVHD ( G-BM , 22 % ; G-PBSC , 80 % ; P < .02 ) , and prolonged requirement for immunosuppressive therapy ( G-BM , 173 days ; G-PBSC , 680 days ; P < .009 ) . Survival was similar for the 2 groups . Compared with G-PBSC , the use of G-BM result ed in comparable engraftment , reduced severity of acute GVHD , and less subsequent chronic GVHD The use of peripheral blood stem cells ( PBSCs ) is rapidly growing in the allogeneic transplantation setting as an alternative to bone marrow ( BM ) . We previously reported a higher incidence of chronic graft-versus-host disease ( cGVHD ) associated with  allogeneic PBSC transplantation  in a r and omized trial . In this follow-up report , we analyzed the evolution of cGVHD in the patients ( n = 101 ) enrolled on this study . At a median follow-up of 45 months ( range , 31 - 57 months ) , we found that the 3-year cumulative incidence of cGVHD was 65 % ( 95 % confidence interval [ CI ] 51%-78 % ) in the PBSC group and 36 % ( 95 % CI 23%-49 % ) in the BM group ( P = .004 ) . We also found that extensive cGVHD was more frequent in the PBSC group ( 44 % [ 95 % CI 30%-58 % ] vs 17 % [ 95 % CI 7%-27 % ] ; P = .004 ) . The prevalence of cGVHD was always higher in the PBSC arm . Ocular involvement was more frequent in PBSC recipients ( P = .02 ) . Cutaneous and liver involvement was similar among BM and PBSC recipients . Chronic GVHD required multiple courses of immunosuppressive therapy in addition to cyclosporine and corticosteroids during longer periods ( P = .03 ) . Altogether , this translated into longer periods of hospitalization after transplantation in the PBSC group ( P = .04 ) . Finally , we also confirm that cGVHD after PBSC transplantation is associated with an antileukemic effect that is at least as potent as after BM . However , to date , this has not translated into a survival difference , possibly due to the early-stage leukemic status of these patients or to the relatively small size of the study population Cytokine-mobilized peripheral blood is increasingly used instead of bone marrow as the source of cells for allogeneic transplantation . Although cells lead to faster hematologic recovery , their effects on graft-versus-host disease , relapse , and survival are less certain . Between January 1996 and February 2000 , 228 patients with chronic myeloid leukemia , acute myeloid leukemia , or myelodysplasia were r and omized to receive either bone marrow or peripheral blood allografts from HLA-matched siblings . All patients received busulfan and cyclophosphamide as conditioning chemotherapy and cyclosporine and methotrexate as graft-versus-host disease prophylaxis . We compared the times to neutrophil and platelet recovery , acute and chronic graft-versus-host disease , relapse , and overall survival between the groups . The median times to neutrophil recovery were 19 days and 23 days and the times to platelet recovery were 16 days and 22 days in the peripheral blood and bone marrow groups , respectively ( P < .0001 for both comparisons ) . The cumulative incidence of grade s II to IV acute graft-versus-host disease 100 days after transplantation was 44 % in both groups ( hazard ratio , 0.99 ; 95 % confidence interval , 0.66 - 1.49 ; P > .9 ) , and the incidence of extensive chronic graft-versus-host disease at 30 months after transplantation was 40 % with peripheral blood and 30 % with bone marrow ( hazard ratio , 1.23 ; 95 % confidence interval , 0.78 - 1.96 ; P = .37 ) . There was no statistically significant difference in the probability of relapse of the underlying disease between the groups . The probabilities of survival at 30 months after transplantation were 68 % and 60 % in the peripheral blood and bone marrow groups , respectively ( hazard ratio , 0.62 ; 95 % confidence interval , 0.39 - 0.97 ; P = .04 ) . In patients with chronic myeloid leukemia , acute myeloid leukemia , and myelodysplasia undergoing allogeneic transplantation from matched siblings , the use of peripheral blood instead of bone marrow leads to faster hematologic recovery , similar risk of graft-versus-host disease , and improved survival Allogeneic mobilized peripheral blood progenitor cells instead of bone marrow are increasingly used to restore hematopoiesis after myeloablative therapy . Data supporting this important change of clinical practice are scarce . We therefore assigned patients with early leukemias to peripheral blood or bone marrow transplantation ;  the occurrence of acute and chronic graft versus host disease , survival , transplantation-related mortality , and relapse rates were compared . A total of 350 patients between 18 and 55 years of age with acute leukemias in remission or chronic myelogenous leukemia in first chronic phase were r and omized to receive either filgrastim-mobilized peripheral blood progenitor cells or bone marrow cells from HLA-identical sibling donors  after st and ard high-dose chemoradiotherapy .  Neutrophil and platelet recovery occurred significantly faster after transplantation of peripheral blood progenitor cells than after bone marrow transplantation .  Acute graft versus host disease of grade s II-IV was significantly more frequent in recipients of peripheral blood progenitor cells than in recipients of marrow cells ( 52 % vs 39 % , odds ratio 1.74 , 95 % confidence interval 1.12 - 2.69 , P = .013 ) . The cumulative incidence of chronic graft versus host disease was 67 % with peripheral blood progenitor cells and 54 % with bone marrow cells ( hazard ratio 1.67 , 95 % confidence interval 1.15 - 2.42 , P = .0066 ) . The estimated overall probability of survival at 2 years was 65 % with either source of stem cells ( hazard ratio 1.15 , 95 % confidence interval 0.79 - 1.67 , P = .46 ) . Disease-free survival , transplantation-related mortality at day 100 , and relapse rates did not significantly differ between treatment arms . Peripheral blood is an equivalent source of hematopoietic stem cells compared with bone marrow if administered to patients with st and ard-risk leukemias . Long-term observation of patients with different diseases and stages of disease is necessary to ultimately define the role of both sources of stem cells BACKGROUND R and omized trials have shown that the transplantation of filgrastim-mobilized peripheral-blood stem cells from HLA-identical siblings accelerates engraftment but increases the risks of acute and chronic graft-versus-host disease ( GVHD ) , as compared with the transplantation of bone marrow . Some studies have also shown that peripheral-blood stem cells are associated with a decreased rate of relapse and improved survival among recipients with high-risk leukemia . METHODS We conducted a phase 3 , multicenter , r and omized trial of transplantation of peripheral-blood stem cells versus bone marrow from unrelated donors to compare 2-year survival probabilities with the use of an intention-to-treat analysis . Between March 2004 and September 2009 , we enrolled 551 patients at 48 centers . Patients were r and omly assigned in a 1:1 ratio to peripheral-blood stem-cell or bone marrow transplantation , stratified according to transplantation center and disease risk . The median follow-up of surviving patients was 36 months ( interquartile range , 30 to 37 ) . RESULTS The overall survival rate at 2 years in the peripheral-blood group was 51 % ( 95 % confidence interval [ CI ] , 45 to 57 ) , as compared with 46 % ( 95 % CI , 40 to 52 ) in the bone marrow group ( P=0.29 ) , with an absolute difference of 5 percentage points ( 95 % CI , -3 to 14 ) . The overall incidence of graft failure in the peripheral-blood group was 3 % ( 95 % CI , 1 to 5 ) , versus 9 % ( 95 % CI , 6 to 13 ) in the bone marrow group ( P=0.002 ) . The incidence of chronic GVHD at 2 years in the peripheral-blood group was 53 % ( 95 % CI , 45 to 61 ) , as compared with 41 % ( 95 % CI , 34 to 48 ) in the bone marrow group ( P=0.01 ) . There were no significant between-group differences in the incidence of acute GVHD or relapse . CONCLUSIONS We did not detect significant survival differences between peripheral-blood stem-cell and bone marrow transplantation from unrelated donors . Exploratory analyses of secondary end points indicated that peripheral-blood stem cells may reduce the risk of graft failure , whereas bone marrow may reduce the risk of chronic GVHD . ( Funded by the National Heart , Lung , and Blood Institute-National Cancer Institute and others ; Clinical Trials.gov number , NCT00075816 . ) In a previous multicenter phase III trial comparing peripheral blood stem cell transplantation ( PBSCT ) to bone marrow transplantation ( BMT ) from HLA-matched related donors , we found no statistically significant difference in the cumulative incidence of clinical extensive chronic graft-versus-host disease ( GVHD ) in the 2 groups . We have analyzed the results in more detail to determine whether the clinical characteristics of chronic GVHD after PBSCT might be distinct from those that occur after BMT .  Clinical extensive chronic GVHD developed in 39 of 63 recipients of PBSCs  and in 32 of 63 BM recipients who were alive and free of malignancy at day 100 after the transplantation . No significant differences were found in the time and type of onset of clinical extensive chronic GVHD or in the frequency of complications associated with severe morbidity . Involvement of skin and female genital tract was more frequent in PBSC recipients than in BM recipients . The cumulative incidence of chronic GVHD at 3 years was similar in the 2 groups , but the number of successive treatments needed to control chronic GVHD was higher after PBSCT than after BMT ( P = .03 ) , and the duration of glucocorticoid treatment was longer after PBSCT compared to BMT ( P = .03 ) . These results suggest that chronic GVHD after PBSCT may be more protracted and less responsive to current treatment than chronic GVHD after BMT . Assessment of the overall benefits of PBSCT compared to BMT will require continued long-term follow up of morbidity associated with chronic GVHD Very few data are available on the comparison of infectious complications in  peripheral blood stem cell transplantation ( PBSCT ) and bone marrow transplant ( BMT ) . The objective of this study was to evaluate the severity and frequency of infectious complications in patients r and omized to receive PBSCT or BMT .  We retrospectively review ed the charts of all patients included in a r and omized clinical trial comparing PBSCT ( 27 patients ) and BMT ( 29 patients ) . We analyzed two periods : pre-engraftment and post-engraftment . In the pre-engraftment period , we compared the two groups with respect to the duration of neutrop 
    Output:
    
This systematic review found high- quality evidence that overall survival following allo-HSCT using the current clinical st and ard stem cell source - peripheral blood stem cells - was similar to that following allo-HSCT using bone marrow stem cells in adults with haematological malignancies .
Nevertheless , our findings are comparable to those of previous meta-analyses suggesting that our results hold true for today 's practice