Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pascal, L; Tucunduva, L; Ruggeri, A; Blaise, D; Ceballos, P; Chevallier, P; Cornelissen, J; Maillard, N; Tabrizi, R; Petersen, E; Linkesch, W; Sengeloev, H; Kenzey, C; Pagliuca, A; Holler, E; Einsele, H; Gluckman, E; Rocha, V; Yakoub-Agha, I; Eurocord and the European Society for Blood and Marrow Transplantation.
Impact of ATG-containing reduced-intensity conditioning after single- or double-unit allogeneic cord blood transplantation.
Blood. 2015; 126(8):1027-1032
Doi: 10.1182/blood-2014-09-599241
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- Co-Autor*innen der Med Uni Graz
- Lechner Evelyne
- Linkesch Werner
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- Abstract:
- We analyzed 661 adult patients who underwent single-unit (n = 226) or double-unit (n = 435) unrelated cord blood transplantation (UCBT) following a reduced-intensity conditioning (RIC) consisting of low-dose total body irradiation (TBI), cyclophosphamide, and fludarabine (Cy/Flu/TBI200). Eighty-two patients received rabbit antithymocyte globulin (ATG) as part of the conditioning regimen (ATG group), whereas 579 did not (non-ATG group). Median age at UCBT was 54 years, and diagnoses were acute leukemias (51%), myelodysplastic syndrome/myeloproliferative neoplasm (19%), and lymphoproliferative diseases (30%). Forty-four percent of patients were transplanted with advanced disease. All patients received ≥4 antigens HLA-matched UCBT. Median number of collected total nucleated cells was 4.4 × 10(7)/kg. In the ATG group, on 64 evaluable patients, ATG was discontinued 1 (n = 27), 2 (n = 20), or > 2 days before the graft infusion (n = 17). In multivariate analyses, the use of ATG was associated with decreased incidence of acute graft-versus-host disease (hazard ratio [HR], 0.31; 95% confidence interval [CI], 0.17-0.55; P < .0001), higher incidence of nonrelapse mortality (HR, 1.68; 95% CI, 1.16-2.43; P = .0009), and decreased overall survival (HR, 1.69; 95% CI, 1.19-2.415; P = .003). Collectively, our results suggest that the use of ATG could be detrimental, especially if given too close to graft infusion in adults undergoing UCBT following Cy/Flu/TBI200 regimen. © 2015 by The American Society of Hematology.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Allografts -
- Antilymphocyte Serum - therapeutic use
- Cord Blood Stem Cell Transplantation - methods
- Cyclophosphamide - administration & dosage
- Female -
- Graft vs Host Disease - epidemiology
- Humans -
- Kaplan-Meier Estimate -
- Lymphoproliferative Disorders - drug therapy
- Male -
- Middle Aged -
- Myelodysplastic Syndromes - drug therapy
- Proportional Hazards Models -
- Transplantation Conditioning - methods
- Vidarabine - administration & dosage
- Vidarabine - analogs & derivatives
- Whole-Body Irradiation -
- Young Adult -