TY - JOUR
T1 - Impact of ATG-containing reduced-intensity conditioning after single- or double-unit allogeneic cord blood transplantation
AU - Pascal, Laurent
AU - Tucunduva, Luciana
AU - Ruggeri, Annalisa
AU - Blaise, Didier
AU - Ceballos, Patrice
AU - Chevallier, Patrice
AU - Cornelissen, Jan
AU - Maillard, Natacha
AU - Tabrizi, Reza
AU - Petersen, Eefke
AU - Linkesch, Werner
AU - Sengeloev, Henrik
AU - Kenzey, Chantal
AU - Pagliuca, Antonio
AU - Holler, Ernst
AU - Einsele, Hermann
AU - Gluckman, Eliane
AU - Rocha, Vanderson
AU - Yakoub-Agha, Ibrahim
AU - Eurocord, null
AU - European Society for Blood, Society for Blood
PY - 2015/8/20
Y1 - 2015/8/20
N2 - 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 × 107/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.
AB - 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 × 107/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.
UR - http://www.scopus.com/inward/record.url?scp=84940036179&partnerID=8YFLogxK
U2 - 10.1182/blood-2014-09-599241
DO - 10.1182/blood-2014-09-599241
M3 - Article
C2 - 26160301
AN - SCOPUS:84940036179
SN - 0006-4971
VL - 126
SP - 1027
EP - 1032
JO - Blood
JF - Blood
IS - 8
ER -