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Reduced-intensity conditioning with busulfan and fludarabine with or without antithymocyte globulin in HLA-identical sibling transplantation--a retrospective analysis.
Bone Marrow Transplant. 2004 Mar; 33(5):483-90.BM

Abstract

It is unknown whether the addition of antithymocyte globulin (ATG) to reduced-intensity conditioning with busulfan (BU) and fludarabine (FLU) is beneficial in HLA-identical sibling transplantation. Therefore, we analyzed retrospectively data on 83 patients, who received peripheral blood stem cells from HLA-identical siblings after conditioning with either 8 mg/kg BU and 150 mg/m2 FLU (n=45) or 8 mg/kg BU, 180 mg/m2 FLU and 40 mg/kg ATG (n=38). Graft-versus-host disease (GVHD) prophylaxis consisted of CSA alone (n=32) or a combination with either MTX or MMF (n=51). The median age was 52 years. Graft failure occurred in two patients after BU/FLU and in three after BU/FLU/ATG (P=0.66). After conditioning with BU/FLU, platelet recovery was significantly faster (P=0.017), and less platelet (P<0.001) and red blood cell (P=0.002) support was needed. Incidences of acute GVHD grades II and IV were 46 and 49%, respectively. Limited chronic GVHD occurred more often after BU/FLU compared to BU/FLU/ATG (54 vs 23%, P=0.02). The overall survival, non-relapse and relapse mortality did not differ significantly. We conclude that in peripheral blood stem cell transplantation from HLA-identical siblings after reduced-intensity conditioning with BU and FLU, ATG has no major impact on the rate of graft rejection and acute GVHD, but it reduces the incidence of limited chronic GVHD.

Authors+Show Affiliations

Charité Campus Virchow Klinikum, Humboldt-Universität zu Berlin, Klinik für Innere Medizin mS Hämatologie und Onkologie, Berlin, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14716342

Citation

Schetelig, J, et al. "Reduced-intensity Conditioning With Busulfan and Fludarabine With or Without Antithymocyte Globulin in HLA-identical Sibling Transplantation--a Retrospective Analysis." Bone Marrow Transplantation, vol. 33, no. 5, 2004, pp. 483-90.
Schetelig J, Bornhäuser M, Kiehl M, et al. Reduced-intensity conditioning with busulfan and fludarabine with or without antithymocyte globulin in HLA-identical sibling transplantation--a retrospective analysis. Bone Marrow Transplant. 2004;33(5):483-90.
Schetelig, J., Bornhäuser, M., Kiehl, M., Schwerdtfeger, R., Kröger, N., Runde, V., Zabelina, T., Held, T. K., Thiede, C., Fauser, A. A., Beelen, D., Zander, A., Ehninger, G., & Siegert, W. (2004). Reduced-intensity conditioning with busulfan and fludarabine with or without antithymocyte globulin in HLA-identical sibling transplantation--a retrospective analysis. Bone Marrow Transplantation, 33(5), 483-90.
Schetelig J, et al. Reduced-intensity Conditioning With Busulfan and Fludarabine With or Without Antithymocyte Globulin in HLA-identical Sibling Transplantation--a Retrospective Analysis. Bone Marrow Transplant. 2004;33(5):483-90. PubMed PMID: 14716342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced-intensity conditioning with busulfan and fludarabine with or without antithymocyte globulin in HLA-identical sibling transplantation--a retrospective analysis. AU - Schetelig,J, AU - Bornhäuser,M, AU - Kiehl,M, AU - Schwerdtfeger,R, AU - Kröger,N, AU - Runde,V, AU - Zabelina,T, AU - Held,T K, AU - Thiede,C, AU - Fauser,A A, AU - Beelen,D, AU - Zander,A, AU - Ehninger,G, AU - Siegert,W, AU - ,, PY - 2004/1/13/pubmed PY - 2004/9/29/medline PY - 2004/1/13/entrez SP - 483 EP - 90 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 33 IS - 5 N2 - It is unknown whether the addition of antithymocyte globulin (ATG) to reduced-intensity conditioning with busulfan (BU) and fludarabine (FLU) is beneficial in HLA-identical sibling transplantation. Therefore, we analyzed retrospectively data on 83 patients, who received peripheral blood stem cells from HLA-identical siblings after conditioning with either 8 mg/kg BU and 150 mg/m2 FLU (n=45) or 8 mg/kg BU, 180 mg/m2 FLU and 40 mg/kg ATG (n=38). Graft-versus-host disease (GVHD) prophylaxis consisted of CSA alone (n=32) or a combination with either MTX or MMF (n=51). The median age was 52 years. Graft failure occurred in two patients after BU/FLU and in three after BU/FLU/ATG (P=0.66). After conditioning with BU/FLU, platelet recovery was significantly faster (P=0.017), and less platelet (P<0.001) and red blood cell (P=0.002) support was needed. Incidences of acute GVHD grades II and IV were 46 and 49%, respectively. Limited chronic GVHD occurred more often after BU/FLU compared to BU/FLU/ATG (54 vs 23%, P=0.02). The overall survival, non-relapse and relapse mortality did not differ significantly. We conclude that in peripheral blood stem cell transplantation from HLA-identical siblings after reduced-intensity conditioning with BU and FLU, ATG has no major impact on the rate of graft rejection and acute GVHD, but it reduces the incidence of limited chronic GVHD. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/14716342/Reduced_intensity_conditioning_with_busulfan_and_fludarabine_with_or_without_antithymocyte_globulin_in_HLA_identical_sibling_transplantation__a_retrospective_analysis_ L2 - https://doi.org/10.1038/sj.bmt.1704384 DB - PRIME DP - Unbound Medicine ER -