Antithymocyte globulin in reduced-intensity conditioning regimen allows a high disease-free survival exempt of long-term chronic graft-versus-host disease

Raynier Devillier, Sabine Fürst, Jean El-Cheikh, Luca Castagna, Samia Harbi, Angela Granata, Roberto Crocchiolo, Claire Oudin, Bilal Mohty, Reda Bouabdallah, Christian Chabannon, Anne Marie Stoppa, Aude Charbonnier, Florence Broussais-Guillaumot, Boris Calmels, Claude Lemarie, JèrÔme Rey, Norbert Vey, Didier Blaise

Research output: Contribution to journalArticlepeer-review

Abstract

Nonmyeloablative (NMA) regimens allow the use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients considered unfit for standard myeloablative conditioning (MAC) regimens using high-dose alkylating agents with or without total body irradiation (TBI). Reduced-intensity conditioning (RIC) regimens, based on fludarabine (Flu), busulfan (Bu), and rabbit antithymocyte globulin (r-ATG), represent an intermediate alternative between NMA and MAC regimens. This platform was subsequently optimized by the introduction of i.v. Bu and the use of 5mg/kg r-ATG, based on the hypothesis that these modifications would improve the safety of RIC allo-HSCT. Here we report a study conducted at our institution on 206 patients, median age 59years, who underwent allo-HSCT after conditioning with Flu, 2days of i.v. Bu, and 5mg/kg r-ATG (FBx-ATG) between 2005 and 2012. The prevalence of grade III-IV acute graft-versus-host disease (GVHD) was 9%, and that of extensive chronic GVHD was 22%. Four-year nonrelapse mortality (NRM), relapse, and overall survival (OS) rates were 22%, 36%, and 54%, respectively. NRM tended to be influenced by comorbidities (hematopoietic cell transplantation-specific comorbidity index [HCT-CI]

Original languageEnglish
Pages (from-to)370-374
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 2014

Keywords

  • Allogeneic stem cell transplantation
  • Antithymocyte globulin
  • Reduced-intensity conditioning

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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