Randomized study of 2 reduced-intensity conditioning strategies for human leukocyte antigen-matched, related allogeneic peripheral blood stem cell transplantation: Prospective clinical and socioeconomic evaluation

Didier Blaise, Reza Tabrizi, Jean Marie Boher, Anne Gaëlle Le Corroller-Soriano, Jacques Olivier Bay, Nathalie Fegueux, Jean Michel Boiron, Sabine Fürst, Luca Castagna, Christian Chabannon, Agnes Boyer-Chammard, Noël Milpied, Hélène Labussière-Wallet, Catherine Faucher, Valerie Jeanne Bardou, Mohamad Mohty, Mauricette Michallet

Research output: Contribution to journalArticle

Abstract

Background: The optimal intensity of reduced-intensity conditioning (RIC) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains uncertain. Methods: In this centrally randomized phase 2 study, the authors compared 2 different strategies of RIC. In total, 139 patients (median age, 54 years; range, 21-65 years) with hematologic malignancies underwent allo-HSCT from a human leukocyte antigen-identical sibling after conditioning combining fludarabine with either busulfan and rabbit antithymocyte-globulin (BU-rATG) (n = 69) or total body irradiation (TBI) (n = 70). Postgraft immunosuppression consisted of cyclosporin A in all patients with the addition of mycophenolate-mophetil after TBI. Results: The median follow-up was 54 months (range, 26-88 months). One-year overall survival rate was identical in both groups. Four patients experienced graft-failure after TBI. The incidence of grade 2 through 4 acute graft-versus-host-disease was greater after BU-rATG than after TBI (47% vs 27%; P =.01), whereas no difference was observed with chronic graft-versus-host-disease. The BU-rATG group had a higher objective response rate (65% vs 46%; P =.05) and a lower relapse rate (27% vs 54%; P

Original languageEnglish
Pages (from-to)602-611
Number of pages10
JournalCancer
Volume119
Issue number3
DOIs
Publication statusPublished - Feb 1 2013

Keywords

  • allogenic hematopoietic stem cell transplantation
  • conditioning
  • hematologic malignancies
  • reduced intensity
  • socioeconomic evaluation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Blaise, D., Tabrizi, R., Boher, J. M., Le Corroller-Soriano, A. G., Bay, J. O., Fegueux, N., Boiron, J. M., Fürst, S., Castagna, L., Chabannon, C., Boyer-Chammard, A., Milpied, N., Labussière-Wallet, H., Faucher, C., Bardou, V. J., Mohty, M., & Michallet, M. (2013). Randomized study of 2 reduced-intensity conditioning strategies for human leukocyte antigen-matched, related allogeneic peripheral blood stem cell transplantation: Prospective clinical and socioeconomic evaluation. Cancer, 119(3), 602-611. https://doi.org/10.1002/cncr.27786