Two days of antithymocyte globulin are associated with a reduced incidence of acute and chronic graft-versus-host disease in reduced-intensity conditioning transplantation for hematologic diseases

Roberto Crocchiolo, Benjamin Esterni, Luca Castagna, Sabine Fürst, Jean El-Cheikh, Raynier Devillier, Angela Granata, Claire Oudin, Boris Calmels, Christian Chabannon, Réda Bouabdallah, Norbert Vey, Didier Blaise

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The optimal combination of fludarabine, busulfan, and antithymocyte globulin (ATG) for reduced-intensity conditioning (RIC) transplantation has not been established. ATG plays a pivotal role in the prevention of graft-versus-host disease (GvHD), but it is associated with a higher relapse rate and an elevated incidence of infections when high doses are used. METHODS: The authors retrospectively compared 2 different doses of ATG combined with fludarabine and busulfan in 229 adult patients who underwent transplantation at their institution. ATG was administered over 1 day (FBA1) or over 2 days (FBA2) at a daily dose of 2.5 mg/kg. RESULTS: There were 124 patients in the FBA2 cohort and 105 patients in the FBA2 cohorts. Patients in the FBA2 cohort were older and more frequently underwent transplantation from an unrelated donor; 93% of patients in the FBA2 cohort received intravenous busulfan versus only 5% in the FBA1 cohort. The incidence of grade 2 through 4 acute GvHD was 23% in the FBA2 cohort versus 42% in the FBA1 cohort (P =.002); the incidence of grade 3 through 4 acute GvHD was 10% versus 23%, respectively (P =.006); and the incidence of chronic GvHD was 35% versus 69%, respectively (P

Original languageEnglish
Pages (from-to)986-992
Number of pages7
JournalCancer
Volume119
Issue number5
DOIs
Publication statusPublished - Mar 1 2013

Keywords

  • allogeneic stem cell transplantation
  • antithymocyte globulin
  • graft-versus-host disease
  • reduced-intensity conditioning
  • relapse

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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  • Cite this

    Crocchiolo, R., Esterni, B., Castagna, L., Fürst, S., El-Cheikh, J., Devillier, R., Granata, A., Oudin, C., Calmels, B., Chabannon, C., Bouabdallah, R., Vey, N., & Blaise, D. (2013). Two days of antithymocyte globulin are associated with a reduced incidence of acute and chronic graft-versus-host disease in reduced-intensity conditioning transplantation for hematologic diseases. Cancer, 119(5), 986-992. https://doi.org/10.1002/cncr.27858