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15 May 2014
Article (Scientific journals)
Antithymocyte globulin before allogeneic stem cell transplantation for progressive myelodysplastic syndrome : a study from the French Society of Bone Marrow Transplantation and Cellular Therapy
Duléry, Rémy; Mohty, Mohamad; Duhamel, Alain et al.
2014 • In Biology of Blood and Marrow Transplantation, 20, p. 646-654
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Keywords :
Conditioning regime; graft-versus-host disease; myelodysplastic syndrome; allogeneic stem cell; transplantation; antithymocyte globulin
Abstract :
[en] We investigated the impact of rabbit antithymocyte globulins (ATG) on patient outcomes after allogeneic stem cell transplantation (allo-SCT) for progressive myelodysplastic syndrome (MDS). Of the 242 consecutive patients who underwent allo-SCT for progressive MDS between October 1999 and December 2009, 93 received ATG (ATG group) at the median dose of 5 mg/kg, whereas 149 patients did not (no-ATG group). Donors were sibling (n ¼ 153) or HLA-matched unrelated (n ¼ 89). Patients received blood (n ¼ 90) or marrow (n ¼ 152) grafts after either myeloablative (n ¼ 109) or reduced-intensity (n ¼ 133) conditioning. Three-year overall and event-free survival, nonrelapse mortality, relapse, and chronic graft-versus-host disease (GVHD) development were not significantly different between the 2 groups. In contrast, acute grade II to IV GVHD occurred more often in the no-ATG group (55% of the patients) than in the ATG group (27%, P < .0001). Similar results were observed with acute grade III to IV GVHD (28% and 14% in the no-ATG group and ATG group, respectively; P ¼ .009). In multivariate analysis, after adjustment with propensity score, the absence of ATG was the strongest parameter associated with an increased risk of acute grade II to IV GVHD (hazard ratio, 2.13; 95% confidence interval, 1.35 to 3.37; P ¼.001]. ATG had no impact on overall and event-free survival or cumulative incidence of the relapse. In conclusion, the addition of ATG to allo-SCT conditioning did not increase the incidence of relapse of patients with progressive MDS. The incidence of acute GVHD was decreased without compromising outcomes.
Disciplines :
Hematology
Author, co-author :
Duléry, Rémy
Mohty, Mohamad
Duhamel, Alain
Robin, Marie
BEGUIN, Yves  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Michallet, Mauricette
Vigouroux, Stéphane
Lioure, Bruno
Garnier, Alice
El Cheikh, Jean
Bulabois, Claude-Eric
Huynh, Anne
Bay, Jacques-Olivier
Daguindau, Etienne
Ceballos, Patrice
Clément, Laurence
Dauriac, Charles
Maillard, Natacha
Legrand, Faezeh
Cornillon, Jérôme
Guillerm, Gaëlle
François, Sylvie
Lapusan, Simona
Chevallier, Patrice
Damaj, Gandhi
Yakoub-Agha, Ibrahim
More authors (16 more) Less
Language :
English
Title :
Antithymocyte globulin before allogeneic stem cell transplantation for progressive myelodysplastic syndrome : a study from the French Society of Bone Marrow Transplantation and Cellular Therapy
Publication date :
2014
Journal title :
Biology of Blood and Marrow Transplantation
ISSN :
1083-8791
eISSN :
1523-6536
Publisher :
Carden Jennings Publishing, Charlottesville, United States - Virginia
Volume :
20
Pages :
646-654
Peer reviewed :
Peer Reviewed verified by ORBi

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