Article (Scientific journals)
Impact of antithymocyte globulin doses in reduced intensity conditioning before allogeneic transplantation from matched sibling donor for patients with acute myeloid leukemia: a report from the acute leukemia working party of European group of Bone Marrow Transplantation.
Devillier, Raynier; Labopin, Myriam; Chevallier, Patrice et al.
2018In Bone Marrow Transplantation, 53, p. 431-437
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Abstract :
[en] Antithymocyte globulin (ATG) is commonly used for graft-vs.-host disease (GVHD) prophylaxis in unrelated donor allogeneic transplantation (Allo-HSCT). However, its use is still controversial in matched sibling donor (MSD) Allo-HSCT, notably after reduced intensity conditioning (RIC). ATG dose may influence the outcome, explaining in part the discordant conclusions in MSD Allo-HSCT. We, therefore, analyzed the impact of ATG doses in patients with acute myeloid leukemia in first complete remission undergoing RIC Allo-HSCT from a MSD. We analyzed 234 patients from the EBMT registry and compared outcome according to given ATG dose (high dose: >/= 6 mg/kg, n = 39 or low dose: < 6 mg/kg, n = 195). No difference was found in the cumulative incidence of acute (grade 2-4: high dose vs. low dose: 21% vs. 13%, p = 0.334; adjusted hazard ratio (HR): 1.20, p = 0.712) and chronic GVHD (extensive: high dose vs. low dose: 19% vs. 18%, p = 0.897; adjusted HR: 1.01, p = 0.980). In contrast, high dose of ATG significantly increased the incidence of relapse (52% vs. 26%, p = 0.011; adjusted HR: 1.31, p = 0.001) leading to impaired outcome (HR progression-free survival (PFS): 1.23, p = 0.002; HR overall survival (OS): 1.17, p = 0.029; HR GVHD and relapse-free survival (GRFS): 1.20, p = 0.005). We conclude that an ATG dose <6 mg/kg is sufficient for GVHD prophylaxis, while higher doses impair disease control and outcome.
Disciplines :
Hematology
Author, co-author :
Devillier, Raynier
Labopin, Myriam
Chevallier, Patrice
Ledoux, Marie-Pierre
Socie, Gerard
Huynh, Anne
Bourhis, Jean-Henri
Cahn, Jean-Yves
Roth-Guepin, Gabrielle
Mufti, Ghulam
Desmier, Deborah
Michallet, Mauricette
Fegueux, Nathalie
Ciceri, Fabio
Baron, Frédéric  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Blaise, Didier
Nagler, Arnon
Mohty, Mohamad
More authors (8 more) Less
Language :
English
Title :
Impact of antithymocyte globulin doses in reduced intensity conditioning before allogeneic transplantation from matched sibling donor for patients with acute myeloid leukemia: a report from the acute leukemia working party of European group of Bone Marrow Transplantation.
Publication date :
2018
Journal title :
Bone Marrow Transplantation
ISSN :
0268-3369
eISSN :
1476-5365
Publisher :
Nature Publishing Group, United Kingdom
Volume :
53
Pages :
431-437
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 19 January 2018

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