Impact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning allo-SCT from a HLA-identical sibling donor: a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation

Impact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning allo-SCT from a HLA-identical sibling donor : a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation

Labopin, M. (author): Hospital Saint Antoine / Pierre-and-Marie-Curie University, Paris, France

Craddock, C. (author): Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, UK

Jindra, P. (author): Charles University Medical School and Teaching Hospital, Pilsen, Czech Republic

Sandstedt, A. (author): Östergötlands Läns Landsting,Hematologiska kliniken US

Mohty, M. (author): Hospital Saint Antoine / Pierre-and-Marie-Curie University, Paris, France

(creator_code:org_t)

2014-01-13
2014
English.
In: Bone Marrow Transplantation. - : Nature Publishing Group. - 0268-3369 .- 1476-5365. ; 49:3, s. 389-396

Related links:: https://www.nature.c...; show more...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Abstract Subject headings

The impact of in vivo T-cell depletion on transplantation outcomes in patients transplanted with reduced-intensity conditioning (RIC) remains controversial. This study assessed the outcome of 1250 adult patients with de novo AML in first CR (CR1) given PBSC from HLA-identical siblings after chemotherapy-based RIC. A total of 554 patients did not receive any form of in vivo T-cell depletion (control group), whereas antithymocyte globulin (ATG) and alemtuzumab were given in 444 and 252 patients, respectively. The incidences of grade II-IV acute GVHD were 21.4, 17.6 and 10.2% in control, ATG and alemtuzumab patients, respectively (P less than 0.001). In multivariate analysis, the use of ATG and the use of alemtuzumab were each associated with a lower risk of chronic GVHD (P less than 0.001 each), but a similar risk of relapse, and of nonrelapse mortality, and similar leukemia-free survival and OS. Further, among patients given BU-based RIC, the use of less than 6 mg/kg ATG did not increase the risk of relapse (hazard ratio, HR=1.1), whereas there was a suggestion for higher relapse risk in patients given greater than= 6 mg/kg ATG (HR=1.4, P=0.08). In summary, these data suggest that a certain amount of in vivo T-Cell depletion can be safely used in the conditioning of AML patients in CR1 given PBSC after chemotherapy-based RIC.

By the author/editor: Baron, F.; Labopin, M.; Blaise, D.; Lopez-Corral, L.; Vigouroux, S.; Craddock, C.; show more...; Attal, M.; Jindra, P.; Goker, H.; Socie, G.; Chevallier, P.; Browne, P.; Sandstedt, A.; Duarte, R. F.; Nagler, A.; Mohty, M.; show less...

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