TY - JOUR
T1 - Multicenter Experience Using Total Lymphoid Irradiation and Antithymocyte Globulin as Conditioning for Allografting in Hematological Malignancies
AU - Messina, Giuseppe
AU - Giaccone, Luisa
AU - Festuccia, Moreno
AU - Irrera, Giuseppe
AU - Scortechini, Ilaria
AU - Sorasio, Roberto
AU - Gigli, Federica
AU - Passera, Roberto
AU - Cavattoni, Irene
AU - Filippi, Andrea Riccardo
AU - Schianca, Fabrizio Carnevale
AU - Pini, Massimo
AU - Risitano, Antonio M.
AU - Selleri, Carmine
AU - Levis, Alessandro
AU - Mordini, Nicola
AU - Gallamini, Andrea
AU - Pastano, Rocco
AU - Casini, Marco
AU - Aglietta, Massimo
AU - Montanari, Mauro
AU - Console, Giuseppe
AU - Boccadoro, Mario
AU - Ricardi, Umberto
AU - Bruno, Benedetto
PY - 2012/10
Y1 - 2012/10
N2 - A non myeloablative conditioning with total lymphoid irradiation (TLI) and antithymocyte globulin (ATG) was shown to protect against graft-versus-host disease (GVHD). To evaluate the effects of TLI-ATG in a multicenter study, 45 heavily pretreated patients, median age 51, with lymphoid (n = 38) and myeloid (n = 7) malignancies were enrolled at 9 centers. Twenty-eight patients (62%) received at least 3 lines of treatment before allografting, and 13 (29%) had refractory/relapsed disease at the time of transplantation. Peripheral blood hematopoietic cells were from HLA identical sibling (n = 30), HLA-matched (n = 9), or 1 antigen HLA-mismatched (n = 6) unrelated donors. A cumulative TLI dose of 8 Gy was administered from day -11 through -1 with ATG at the dose of 1.5 mg/kg/day (from day -11 through -7). GVHD prophylaxis consisted of cyclosporine and mycophenolate mofetil. Donor engraftment was reached in 95% of patients. Grade II to IV acute GVHD (aGVHD) developed in 6 patients (13.3%), and in 2 of these patients, it developed beyond day 100. Incidence of chronic GVHD (cGVHD) was 35.8%. One-year nonrelapse mortality was 9.1%. After a median follow-up of 28 months (range, 3-57 months) from transplantation, median overall survival was not reached, whereas median event-free survival was 20 months. This multicenter experience confirms that TLI-ATG protects against GVHD and maintains graft-vs-tumor effects.
AB - A non myeloablative conditioning with total lymphoid irradiation (TLI) and antithymocyte globulin (ATG) was shown to protect against graft-versus-host disease (GVHD). To evaluate the effects of TLI-ATG in a multicenter study, 45 heavily pretreated patients, median age 51, with lymphoid (n = 38) and myeloid (n = 7) malignancies were enrolled at 9 centers. Twenty-eight patients (62%) received at least 3 lines of treatment before allografting, and 13 (29%) had refractory/relapsed disease at the time of transplantation. Peripheral blood hematopoietic cells were from HLA identical sibling (n = 30), HLA-matched (n = 9), or 1 antigen HLA-mismatched (n = 6) unrelated donors. A cumulative TLI dose of 8 Gy was administered from day -11 through -1 with ATG at the dose of 1.5 mg/kg/day (from day -11 through -7). GVHD prophylaxis consisted of cyclosporine and mycophenolate mofetil. Donor engraftment was reached in 95% of patients. Grade II to IV acute GVHD (aGVHD) developed in 6 patients (13.3%), and in 2 of these patients, it developed beyond day 100. Incidence of chronic GVHD (cGVHD) was 35.8%. One-year nonrelapse mortality was 9.1%. After a median follow-up of 28 months (range, 3-57 months) from transplantation, median overall survival was not reached, whereas median event-free survival was 20 months. This multicenter experience confirms that TLI-ATG protects against GVHD and maintains graft-vs-tumor effects.
KW - Graft-versus-host disease
KW - Nonmyeloablative conditioning
KW - Total lymphoid irradiation/antithymocyte globulin
UR - http://www.scopus.com/inward/record.url?scp=84866180721&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84866180721&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2012.03.012
DO - 10.1016/j.bbmt.2012.03.012
M3 - Article
C2 - 22484666
AN - SCOPUS:84866180721
VL - 18
SP - 1600
EP - 1607
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 10
ER -