Reduced platelet transfusions and earlier platelet engraftment using alemtuzumab-based conditioning regimen in allogeneic stem cell transplantation

Autor: William Krüger, Laila Schneidewind, Anne Friederike Klenner, Andreas Greinacher, Christoph Busemann, Thomas Thiele, Gottfried Dölken, Thomas Neumann, Meike Schulze, Daniel Pink
Rok vydání: 2016
Předmět:
Adult
Blood Platelets
Male
Cancer Research
Transplantation Conditioning
Platelet Engraftment
medicine.medical_treatment
Graft vs Host Disease
Antineoplastic Agents
Platelet Transfusion
Hematopoietic stem cell transplantation
Antibodies
Monoclonal
Humanized
03 medical and health sciences
0302 clinical medicine
Humans
Transplantation
Homologous
Medicine
Platelet
Alemtuzumab
Aged
Antilymphocyte Serum
Neoplasm Staging
Retrospective Studies
business.industry
Hematopoietic Stem Cell Transplantation
General Medicine
Middle Aged
Prognosis
Combined Modality Therapy
Transplantation
surgical procedures
operative
Platelet transfusion
Oncology
Case-Control Studies
Hematologic Neoplasms
030220 oncology & carcinogenesis
Immunology
Female
Stem cell
business
Follow-Up Studies
030215 immunology
medicine.drug
Zdroj: Journal of Cancer Research and Clinical Oncology. 142:1091-1097
ISSN: 1432-1335
0171-5216
DOI: 10.1007/s00432-016-2114-7
Popis: In patients undergoing allogeneic stem cell transplantation, conditioning regimens containing alemtuzumab instead of anti-thymocyte globulin (ATG) may result in an earlier platelet engraftment and a reduced number of platelet transfusions.We performed a retrospective, single-center, case-control study analyzing time to engraftment and transfusion needs using alemtuzumab in comparison with ATG as part of conditioning protocol.Median values for time to platelet engraftment, number of transfused platelet concentrates and number of transfused red cell concentrates were 12 versus 19.5 days (p0.001), 2 versus 14 (p0.001) and 6 versus 14.5 (p = 0.003) in the alemtuzumab and ATG group. Time to leukocyte engraftment did not differ with median 15 days in both groups. Patients in the ATG group showed a significant higher decrease in platelet count during conditioning (68 vs. 29 %, p = 0.001), leading to significant lower median platelet counts at the day of stem cell infusion (38 vs. 95.5 Gpt/l, p = 0.008), and higher values for median C-reactive protein after first antibody infusion (69.0 vs. 43.6 mg/l, p = 0.001) compared with alemtuzumab group. Test for significance was done by using Wilcoxon rank-sum test. Subgroup analysis considering the type of ATG used (Thymoglobulin vs. ATG Fresenius) revealed that differences between alemtuzumab and ATG group were more due to effects of ATG Fresenius than Thymoglobulin.The use of alemtuzumab in comparison with ATG as part of the conditioning regimen may be an approach to reduce the number of transfused platelet and red cell concentrates after allogeneic stem cell transplantation.
Databáze: OpenAIRE
Externí odkaz: