Giorgia Battipaglia1,2, Myriam Labopin1,3,4, Rose-Marie Hamladji5, Didier Blaise6, Patrice Chevallier7, Eolia Brissot1,4, Armin Gerbitz8, Gerard Socié9, Boris Afanasyev10, Fabio Ciceri11, Ellen Meijer12, Yener Koc13, Jan J Cornelissen14, Anne Huynh15, Hakan Ozdogu16, Johan Maertens17, Franciane Paul18, Hélène Labussière-Wallet19, Annalisa Ruggeri11, Mahmoud Aljurf20, Ali Bazarbachi21, Bipin Savani22, Arnon Nagler3,23, Mohamad Mohty1,3,4. 1. Hematology Department, Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, Paris, France. 2. Hematology Department, Federico II University, Naples, Italy. 3. Acute Leukemia Working Party of EBMT, Paris, France. 4. Hospital Saint-Antoine, Sorbonne University, INSERM U938, Paris, France. 5. Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria. 6. Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France. 7. CHU Nantes, Department D'Hematologie, Nantes, France. 8. Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Hämatologie/Onkologie, Berlin, Germany. 9. Department of Hematology-BMT, Hopital St. Louis, Paris, France. 10. First State Pavlov Medical University of St. Petersburg, Raisa Gorbacheva Memorial Research Institute for Paediatric Oncology, Hematology, and Transplantation, St. Petersburg, Russia. 11. Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy. 12. Department of Hematology (Br 250), VU University Medical Center, Amsterdam, Netherlands. 13. Medical Park Hospitals, Stem Cell Transplant Unit, Antalya, Turkey. 14. Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. 15. CHU-Institut Universitaire du Cancer Toulouse, Oncopole, Toulouse, France. 16. Haematology Division, BMT Unit, Haematology Research Laboratory, Baskent University Hospital, Adana, Turkey. 17. Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium. 18. Département d`Hématologie Clinique, CHU Lapeyronie, Montpellier, France. 19. Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France. 20. Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. 21. Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. 22. Division of Hematology/Oncology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 23. Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Abstract
BACKGROUND: Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Addition of antithymocyte globulin (ATG) or post-transplantation cyclophosphamide (PTCY) to standard immunosuppressive agents reduces GVHD in different donor settings. METHODS: We compared the outcomes of adults with acute myeloid leukemia undergoing allo-HSCT from HLA-identical sibling donors after the use of PTCY (n = 197) or ATG (n = 1913). RESULTS: Patients in the PTCY group were younger than those in the ATG group (median age, 47 vs 54 years; P < .01). Peripheral blood was the most frequently used stem cell source, being significantly more frequent in the ATG group than in the PTCY group (95% vs 70% P < .01). The conditioning regimen was more frequently myeloablative in the PTCY group than in the ATG group (59% vs 48%; P < .01). Time to neutrophil engraftment was shorter in the ATG group than in the PTCY group (17 vs 20 days; P < .01). No differences were observed according to the other transplantation outcomes, except for chronic GVHD of all grades and extensive chronic GVHD at 2 years, which were significantly lower in the ATG group compared with the PTCY group (P < .02). CONCLUSION: PTCY is feasible in an HLA-identical sibling setting, and despite similar outcomes, ATG may be associated with lower incidence of chronic GVHD.
BACKGROUND:Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Addition of antithymocyte globulin (ATG) or post-transplantation cyclophosphamide (PTCY) to standard immunosuppressive agents reduces GVHD in different donor settings. METHODS: We compared the outcomes of adults with acute myeloid leukemia undergoing allo-HSCT from HLA-identical sibling donors after the use of PTCY (n = 197) or ATG (n = 1913). RESULTS:Patients in the PTCY group were younger than those in the ATG group (median age, 47 vs 54 years; P < .01). Peripheral blood was the most frequently used stem cell source, being significantly more frequent in the ATG group than in the PTCY group (95% vs 70% P < .01). The conditioning regimen was more frequently myeloablative in the PTCY group than in the ATG group (59% vs 48%; P < .01). Time to neutrophil engraftment was shorter in the ATG group than in the PTCY group (17 vs 20 days; P < .01). No differences were observed according to the other transplantation outcomes, except for chronic GVHD of all grades and extensive chronic GVHD at 2 years, which were significantly lower in the ATG group compared with the PTCY group (P < .02). CONCLUSION:PTCY is feasible in an HLA-identical sibling setting, and despite similar outcomes, ATG may be associated with lower incidence of chronic GVHD.
Authors: Lorenzo Lazzari; Aitana Balaguer-Roselló; Jacopo Peccatori; Jaime Sanz; Juan Montoro; Raffaella Greco; Rafael Hernani; Maria Teresa Lupo-Stanghellini; Marta Villalba; Fabio Giglio; Ana Facal; Francesca Lorentino; Manuel Guerreiro; Alessandro Bruno; Ariadna Pérez; Elisabetta Xue; Daniela Clerici; Simona Piemontese; José Luis Piñana; Miguel Ángel Sanz; Carlos Solano; Javier de la Rubia; Fabio Ciceri Journal: Bone Marrow Transplant Date: 2022-06-09 Impact factor: 5.174
Authors: Moniek de Witte; Laura G M Daenen; Lotte van der Wagen; Anna van Rhenen; Reiner Raymakers; Kasper Westinga; Jürgen Kuball Journal: Hemasphere Date: 2021-06-01