The role of anti-thymocyte globulin in allogeneic stem cell transplantation (HSCT) from HLA-matched unrelated donors (MUD) for secondary AML in remission: a study from the ALWP /EBMT
Standard
The role of anti-thymocyte globulin in allogeneic stem cell transplantation (HSCT) from HLA-matched unrelated donors (MUD) for secondary AML in remission: a study from the ALWP /EBMT. / Nagler, Arnon; Labopin, Myriam; Kröger, Nicolaus; Schroeder, Thomas; Gedde-Dahl, Tobias; Eder, Matthias; Franke, Georg-Nikolaus; Blau, Igor Wolfgang; Salmenniemi, Urpu; Socie, Gerard; Schetelig, Johannes; Stelljes, Matthias; Ciceri, Fabio; Mohty, Mohamad.
in: BONE MARROW TRANSPL, Jahrgang 58, Nr. 12, 12.2023, S. 1339-1347.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - The role of anti-thymocyte globulin in allogeneic stem cell transplantation (HSCT) from HLA-matched unrelated donors (MUD) for secondary AML in remission: a study from the ALWP /EBMT
AU - Nagler, Arnon
AU - Labopin, Myriam
AU - Kröger, Nicolaus
AU - Schroeder, Thomas
AU - Gedde-Dahl, Tobias
AU - Eder, Matthias
AU - Franke, Georg-Nikolaus
AU - Blau, Igor Wolfgang
AU - Salmenniemi, Urpu
AU - Socie, Gerard
AU - Schetelig, Johannes
AU - Stelljes, Matthias
AU - Ciceri, Fabio
AU - Mohty, Mohamad
N1 - © 2023. The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/12
Y1 - 2023/12
N2 - We compared outcomes, of 1609 patients with secondary acute myeloid leukemia (sAML) undergoing allogeneic transplantation (HSCT) in first complete remission (CR1) from matched unrelated donors (MUD) from 2010 to 2021, receiving or not receiving anti-thymocyte globulin (ATG) (ATG-1308, no ATG-301). Median age was 60.9 (range, 18.5-77.8) and 61.1 (range, 21.8-75.7) years, (p = 0.3). Graft versus host disease (GVHD) prophylaxis was cyclosporin-A with methotrexate (41%) or mycophenolate mofetil (38.2%), without significant differences between groups. Day 28, engraftment (ANC > 0.5 × 109/L) was 92.3% vs 95.3% (p = 0.17), respectively. On multivariate analysis, ATG was associated with lower incidence of grade II-IV and grade III-IV acute GVHD (p = 0.002 and p = 0.015), total and extensive chronic GVHD (p = 0.008 and p < 0.0001), and relapse incidence (RI) (p = 0.039), while non-relapse mortality (NRM) did not differ (p = 0.51). Overall survival (OS), and GVHD-free, relapse-free survival (GRFS) were significantly higher in the ATG vs no ATG group, HR = 0.76 (95% CI 0.61-0.95, p = 0.014) and HR = 0.68 (95% CI 0.57-0.8, p < 0.0001), with a tendency for better leukemia-free survival (LFS), HR = 0.82 (95% CI 0.67-1, p = 0.051). The main causes of death were the original disease, infection, and GVHD. In conclusion, ATG reduces GVHD and improves LFS, OS, and GRFS in sAML patients without increasing the RI, despite sAML being a high-risk disease.
AB - We compared outcomes, of 1609 patients with secondary acute myeloid leukemia (sAML) undergoing allogeneic transplantation (HSCT) in first complete remission (CR1) from matched unrelated donors (MUD) from 2010 to 2021, receiving or not receiving anti-thymocyte globulin (ATG) (ATG-1308, no ATG-301). Median age was 60.9 (range, 18.5-77.8) and 61.1 (range, 21.8-75.7) years, (p = 0.3). Graft versus host disease (GVHD) prophylaxis was cyclosporin-A with methotrexate (41%) or mycophenolate mofetil (38.2%), without significant differences between groups. Day 28, engraftment (ANC > 0.5 × 109/L) was 92.3% vs 95.3% (p = 0.17), respectively. On multivariate analysis, ATG was associated with lower incidence of grade II-IV and grade III-IV acute GVHD (p = 0.002 and p = 0.015), total and extensive chronic GVHD (p = 0.008 and p < 0.0001), and relapse incidence (RI) (p = 0.039), while non-relapse mortality (NRM) did not differ (p = 0.51). Overall survival (OS), and GVHD-free, relapse-free survival (GRFS) were significantly higher in the ATG vs no ATG group, HR = 0.76 (95% CI 0.61-0.95, p = 0.014) and HR = 0.68 (95% CI 0.57-0.8, p < 0.0001), with a tendency for better leukemia-free survival (LFS), HR = 0.82 (95% CI 0.67-1, p = 0.051). The main causes of death were the original disease, infection, and GVHD. In conclusion, ATG reduces GVHD and improves LFS, OS, and GRFS in sAML patients without increasing the RI, despite sAML being a high-risk disease.
KW - Humans
KW - Middle Aged
KW - Antilymphocyte Serum/therapeutic use
KW - Unrelated Donors
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Leukemia, Myeloid, Acute/drug therapy
KW - Graft vs Host Disease/etiology
KW - Recurrence
KW - Chronic Disease
KW - Retrospective Studies
KW - Transplantation Conditioning/adverse effects
U2 - 10.1038/s41409-023-02095-0
DO - 10.1038/s41409-023-02095-0
M3 - SCORING: Journal article
C2 - 37660157
VL - 58
SP - 1339
EP - 1347
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 12
ER -