A conditioning platform based on fludarabine, busulfan and two days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor

Autor: Devillier, R., Fürst, S., Crocchiolo, R., El-Cheikh, J., Castagna, L., Harbi, S., Granata, A., D'Incan, E., Coso, D., Chabannon, C., Picard, C., Etienne, A., Calmels, B., Schiano, J. M., Lemarie, C., Stoppa, A. M., Bouabdallah, R., Vey, N., Blaise, D.
Přispěvatelé: Hematology and BMT Unit, San Raffaele Scientific Institute, Unit of Lymphoid Malignancies, Biostatistics Unit, Università degli studi di Genova = University of Genoa (UniGe), Hematology and BMT Unit, Unit of Lymphoid Malignancies, Department of Oncology, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, University of Genoa (UNIGE)
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: American Journal of Hematology
American Journal of Hematology, 2014, 89 (1), pp.83-7. ⟨10.1002/ajh.23592⟩
American Journal of Hematology, Wiley, 2014, 89 (1), pp.83-7. ⟨10.1002/ajh.23592⟩
ISSN: 0361-8609
1096-8652
Popis: International audience; : Conditioning regimen including fludarabine (FLU), intravenous busulfan (Bx), and 5 mg/kg total dose of rabbit antithymocyte globulin (r-ATG) (FBx-ATG), results in low incidence of graft-versus-host disease (GVHD) and non-relapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) from HLA-matched related or unrelated donors (MUD). However, whether this platform produces similar results in the setting of one mismatch unrelated donor (MMUD) Allo-HSCT is not known. We retrospectively analyzed patients aged less than 65 years who were diagnosed with hematological malignancies and received FBx-ATG regimen prior to Allo-HSCT from MUD (N=74) or MMUD (N=40). We compared outcome of MUD vs. MMUD patients. There was no difference in the cumulative incidence of grade II-IV acute GVHD (MUD: 34% vs. MMUD: 35%, p=0.918), but MMUD patients developed more grade III-IV acute GVHD (MUD: 5% vs. MMUD: 15%, p=0.016). The cumulative incidences of overall chronic GVHD (MUD: 33% vs. MMUD: 22%, p=0.088) and extensive chronic GVHD (MUD: 20% vs. MMUD: 19%, p=0.594) were comparable. One-year NRM was similar in both groups (MUD: 16% vs. MMUD: 14%, p=0.292); similarly, progression-free survival (MUD: 59% vs. MMUD: 55%, p=0.476) and overall survival (MUD: 63% vs. MMUD: 61%, p=0.762) were not different between both groups. With a median follow up of 24 months, 35 of 74 MUD patients (47%) and 19 of 40 MMUD patients (48%) were free of both disease progression and immunosuppressive treatment. We conclude that the FBx-ATG regimen results in low incidences of NRM and GVHD in both MUD and the MMUD recipients.
Databáze: OpenAIRE
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