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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

Baron, F
Author Baron, F Department of Hematology, University of Liège, Liège, Belgium
Labopin, M
Author Labopin, M ] Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France [2] EBMT ALWP Office, Hospital Saint Antoine, Paris, France [3] Universite Pierre et Marie Curie, Paris, France [4] INSERM UMRs 938, Paris, France
Blaise, D
Author Blaise, D Hematology, CHU de Marseille, Marseille, France
Lopez-Corral, L
Author Lopez-Corral, L Hospital Clinico Universitario, Salamanca, Spain
Vigouroux, S
Author Vigouroux, S Hematology, CHU de Bordeaux, Bordeaux, France
Craddock, C
Author Craddock, C Centre for Clinical Haematology, Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, Birmingham, UK
Attal, M
Author Attal, M Hematology, CHU de Toulouse, Toulouse, France
Jindra, P
Author Jindra, P Charles University Medical School and Teaching Hospital, Pilsen, Czech Republic
Goker, H
Author Goker, H BMT Unit, Department of Hematology, Hacettepe University, Ankara, Turkey
Socié, G
Author Socié, G Bone Marrow Transplantation, Saint-Louis Hospital, Paris, France
Chevallier, P
Author Chevallier, P Hematology, CHU de Nantes, Nantes, France
Browne, P
Author Browne, P Hope Directorate, St James's Hospital, Dublin, Ireland, UK
Sandstedt, A
Author Sandstedt, A Department of Hematology, University Hospital, Linköping, Sweden
Duarte, R F
Author Duarte, R F ICO-Hospital Duran i Reynals, l'Hospitalet de Llobregat, Barcelona, Spain
Nagler, A
Author Nagler, A Hematology Division, Sheba medical Center, Tel-Aviv University, Tel-Hashomer, Israel
Mohty, M
Author Mohty, M ] Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France [2] EBMT ALWP Office, Hospital Saint Antoine, Paris, France [3] Universite Pierre et Marie Curie, Paris, France [4] INSERM UMRs 938, Paris, France

Bone marrow transplantation. 2014 Mar ; 49 (3) : 389-96. [epub] 20140113

Bone Marrow Transplant
ISSN 1476-5365 | 0268-3369
Source

Language English Country Great Britain, England Media print-electronic

Document type Journal Article, Multicenter Study

Persistent link https://www.medvik.cz/link/pmid24419525

PubMed 24419525
DOI 10.1038/bmt.2013.204
PII: bmt2013204
Knihovny.cz E-resources

MeSH
Leukemia, Myeloid, Acute blood therapy MeSH
Alemtuzumab MeSH
Antilymphocyte Serum metabolism MeSH
Tissue Donors MeSH
Adult MeSH
HLA Antigens immunology MeSH
Transplantation, Homologous MeSH
Antibodies, Monoclonal, Humanized therapeutic use MeSH
Incidence MeSH
Remission Induction MeSH
Stem Cells cytology MeSH
Middle Aged MeSH
Humans MeSH
Melphalan therapeutic use MeSH
Young Adult MeSH
Multivariate Analysis MeSH
Graft vs Host Disease MeSH
Disease-Free Survival MeSH
Transplantation Conditioning methods MeSH
Proportional Hazards Models MeSH
Recurrence MeSH
Retrospective Studies MeSH
Aged MeSH
Siblings MeSH
T-Lymphocytes cytology MeSH
Treatment Outcome MeSH
Check Tag
Adult MeSH
Middle Aged MeSH
Humans MeSH
Young Adult MeSH
Male MeSH
Aged MeSH
Female MeSH
Publication type
Journal Article MeSH
Multicenter Study MeSH
Geographicals
Europe MeSH
Names of Substances
Alemtuzumab MeSH
Antilymphocyte Serum MeSH
HLA Antigens MeSH
Antibodies, Monoclonal, Humanized MeSH
Melphalan MeSH

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<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<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 <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 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.

] Clinical Hematology and Cellular Therapy Department Hospital Saint Antoine APHP Paris France [2] EBMT ALWP Office Hospital Saint Antoine Paris France [3] Universite Pierre et Marie Curie Paris France [4] INSERM UMRs 938 Paris France

BMT Unit Department of Hematology Hacettepe University Ankara Turkey

Bone Marrow Transplantation Saint Louis Hospital Paris France

Centre for Clinical Haematology Queen Elizabeth Hospital and School of Cancer Studies University of Birmingham Birmingham UK

Charles University Medical School and Teaching Hospital Pilsen Czech Republic

Department of Hematology University Hospital Linköping Sweden

Department of Hematology University of Liège Liège Belgium

Hematology CHU de Bordeaux Bordeaux France

Hematology CHU de Marseille Marseille France

Hematology CHU de Nantes Nantes France

Hematology CHU de Toulouse Toulouse France

Hematology Division Sheba medical Center Tel Aviv University Tel Hashomer Israel