Impact of Thymoglobulin by Stem Cell Source (Peripheral Blood Stem Cell or Bone Marrow) After Myeloablative Stem Cell Transplantation From HLA 10/10-Matched Unrelated Donors. A Report From the Société Française de Greffe de Moelle et de Thérapie Cellulaire
In: ISSN: 0041-1337 ; Transplantation ; https://hal-univ-rennes1.archives-ouvertes.fr/hal-01231422 ; Transplantation, Lippincott, Williams & Wilkins, 2016, 100 (8), pp.1732-1739. ⟨10.1097/TP.0000000000000976⟩, 2016
academicJournal
Zugriff:
International audience ; BACKGROUND: The impact of antithymocyte globulin (ATG) in the setting of a myeloablative conditioning transplantation remains controversial, especially when using bone marrow (BM) as the stem cell source. METHODS: We therefore conducted a retrospective analysis to investigate the impact of ATG in patients with acute myeloid leukemia or myelodysplastic syndrome receiving myeloablative conditioning followed by a matched 10 of 10 unrelated donor transplant from BM or peripheral blood stem cells (PBSCs). Our study included 356 patients conditioned with cyclophosphamide associated with fractionated total body irradiation or busulfan. RESULTS: Median follow-up was 17.6 months (range, 0-156). The ATG and PBSCs were the only variables that independently decreased the cumulative incidence (CI) of chronic graft-versus-host disease (GvHD) (hazards ratio [HR], 0.4; 95% CI, 0.21-0.73; P \textless 0.01; and HR, 0.53; 95% CI, 0.30-0.90; P = 0.02, respectively). The ATG had no impact on overall survival, disease-free survival, relapse, and nonrelapse mortality. In the PBSC group (n = 139), ATG was associated with a lower CI of both grades III to IV acute GvHD (HR, 0.17; 95% CI, 0.03-0.91; P = 0.04), chronic GvHD (HR, 0.31; 95% CI, 0.11-0.87; P = 0.03), and GvHD-free/relapse-free survival (HR, 0.48; 95% CI, 0.29-0.80; P \textless 0.01), whereas these correlations were not significant in the group of patients (n = 217) receiving BM (HR, 0.36; 95% CI, 0.11-1.93; P = 0.06 for grade III-IV acute GvHD; HR, 0.49; 95% CI, 0.22-1.06; P = 0.08 for chronic GvHD; and HR, 0.69; 95% CI, 0.46-1.01; P = 0.06 for GvHD-free/relapse-free survival). CONCLUSIONS: Although our results confirm the recommendation for ATG to be added after PBSC transplantation, no obvious benefit was identified using this approach in the setting of BM transplantation. Only prospective studies may yield definitive answers to this question
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Impact of Thymoglobulin by Stem Cell Source (Peripheral Blood Stem Cell or Bone Marrow) After Myeloablative Stem Cell Transplantation From HLA 10/10-Matched Unrelated Donors. A Report From the Société Française de Greffe de Moelle et de Thérapie Cellulaire
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| Autor/in / Beteiligte Person: | Ravinet, Aurelie ; Cabrespine, Aurélie ; Socie, Gérard ; Milpied, Noel ; Yakoub Agha, Ibrahim ; Nguyen, Stephanie ; Michallet, Mauricette ; Menard, Anne Lise ; Maillard, Natacha ; Mohty, Mohamad ; Suarez, Felipe ; Huynh, Anne ; Marchand, Tony ; Deteix, Clémence ; Cassuto, Jill Patrice ; Maury, Sébastien ; Chevallier, Patrice ; Reman, Oumedaly ; Latour, Régis ; Bay, Jacques Olivier ; Service d’Hématologie Clinique Adulte et de Thérapie Cellulaire ; Clermont-Ferrand, CHU ; EA7283, CIC501 ; Université d'Auvergne - Clermont-Ferrand I (UdA) ; Service d'hématologie greffe Saint-Louis ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal Paris ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7) ; Haematology ; CHU Bordeaux Bordeaux ; Service d'hématologie Hôpital Edouard Herriot -, HCL ; Hôpital Edouard Herriot CHU -, HCL ; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL) ; Hématologie, Service ; Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital Jean Bernard ; Imagine - Institut des maladies génétiques (IMAGINE - U1163) ; Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Microenvironnement et cancer (MiCa) ; Université de Rennes 1 (UR1) ; Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) ; Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) ; INSERM U955, équipe 7 ; Hôpital Henri Mondor ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut Mondor de Recherche Biomédicale (IMRB) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) ; APHP Henri Mondor ; Centre hospitalier universitaire de Nantes (CHU Nantes) ; CHU Henri Mondor |
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| Zeitschrift: | ISSN: 0041-1337 ; Transplantation ; https://hal-univ-rennes1.archives-ouvertes.fr/hal-01231422 ; Transplantation, Lippincott, Williams & Wilkins, 2016, 100 (8), pp.1732-1739. ⟨10.1097/TP.0000000000000976⟩, 2016 |
| Veröffentlichung: | HAL CCSD ; Lippincott, Williams & Wilkins, 2016 |
| Medientyp: | academicJournal |
| DOI: | 10.1097/TP.0000000000000976 |
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