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A conditioning platform based on fludarabine, busulfan, and 2 days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor.
Am J Hematol. 2014 Jan; 89(1):83-7.AJ

Abstract

Conditioning regimen including fludarabine, intravenous busulfan (Bx), and 5 mg/kg total dose of rabbit antithymocyte globulin (r-ATG) (FBx-ATG) results in low incidence of graft-versus-host disease (GVHD) and non-relapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) from HLA-matched related or unrelated donors (MUD). However, whether this platform produces similar results in the setting of one mismatch unrelated donor (MMUD) Allo-HSCT is not known. We retrospectively analyzed patients aged less than 65 years who were diagnosed with hematological malignancies and received FBx-ATG regimen prior to Allo-HSCT from MUD (N = 74) or MMUD (N = 40). We compared outcome of MUD versus MMUD patients. There was no difference in the cumulative incidence of grades II-IV acute GVHD (MUD: 34% vs. MMUD: 35%, P = 0.918), but MMUD patients developed more grade III-IV acute GVHD (MUD: 5% vs. MMUD: 15%, P = 0.016). The cumulative incidences of overall chronic GVHD (MUD: 33% vs. MMUD: 22%, P = 0.088) and extensive chronic GVHD (MUD: 20% vs. MMUD: 19%, P = 0.594) were comparable. One-year NRM was similar in both groups (MUD: 16% vs. MMUD: 14%, P = 0.292); similarly, progression-free survival (MUD: 59% vs. MMUD: 55%, P = 0.476) and overall survival (MUD: 63% vs. MMUD: 61%, P = 0.762) were not different between both groups. With a median follow up of 24 months, 35 of 74 MUD patients (47%) and 19 of 40 MMUD patients (48%) were free of both disease progression and immunosuppressive treatment. We conclude that the FBx-ATG regimen results in low incidences of NRM and GVHD in both MUD and the MMUD recipients.

Authors+Show Affiliations

Département d'Onco-Hématologie, Institut Paoli-Calmettes, Unité de Transplantation et de Thérapie Cellulaire, F-13273, Marseille, France; Aix-Marseille Université, F-13007, Marseille, France; Inserm UMR1068, Centre de Recherche en Cancérologie de Marseille (CRCM), F-13009, Marseille, France.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 availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24108528

Citation

Devillier, Raynier, et al. "A Conditioning Platform Based On Fludarabine, Busulfan, and 2 Days of Rabbit Antithymocyte Globulin Results in Promising Results in Patients Undergoing Allogeneic Transplantation From Both Matched and Mismatched Unrelated Donor." American Journal of Hematology, vol. 89, no. 1, 2014, pp. 83-7.
Devillier R, Fürst S, Crocchiolo R, et al. A conditioning platform based on fludarabine, busulfan, and 2 days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor. Am J Hematol. 2014;89(1):83-7.
Devillier, R., Fürst, S., Crocchiolo, R., El-Cheikh, J., Castagna, L., Harbi, S., Granata, A., D'Incan, E., Coso, D., Chabannon, C., Picard, C., Etienne, A., Calmels, B., Schiano, J. M., Lemarie, C., Stoppa, A. M., Bouabdallah, R., Vey, N., & Blaise, D. (2014). A conditioning platform based on fludarabine, busulfan, and 2 days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor. American Journal of Hematology, 89(1), 83-7. https://doi.org/10.1002/ajh.23592
Devillier R, et al. A Conditioning Platform Based On Fludarabine, Busulfan, and 2 Days of Rabbit Antithymocyte Globulin Results in Promising Results in Patients Undergoing Allogeneic Transplantation From Both Matched and Mismatched Unrelated Donor. Am J Hematol. 2014;89(1):83-7. PubMed PMID: 24108528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A conditioning platform based on fludarabine, busulfan, and 2 days of rabbit antithymocyte globulin results in promising results in patients undergoing allogeneic transplantation from both matched and mismatched unrelated donor. AU - Devillier,Raynier, AU - Fürst,Sabine, AU - Crocchiolo,Roberto, AU - El-Cheikh,Jean, AU - Castagna,Luca, AU - Harbi,Samia, AU - Granata,Angela, AU - D'Incan,Evelyne, AU - Coso,Diane, AU - Chabannon,Christian, AU - Picard,Christophe, AU - Etienne,Anne, AU - Calmels,Boris, AU - Schiano,Jean-Marc, AU - Lemarie,Claude, AU - Stoppa,Anne-Marie, AU - Bouabdallah,Reda, AU - Vey,Norbert, AU - Blaise,Didier, PY - 2013/05/27/received PY - 2013/07/23/revised PY - 2013/09/06/accepted PY - 2013/10/11/entrez PY - 2013/10/11/pubmed PY - 2014/3/29/medline SP - 83 EP - 7 JF - American journal of hematology JO - Am. J. Hematol. VL - 89 IS - 1 N2 - Conditioning regimen including fludarabine, intravenous busulfan (Bx), and 5 mg/kg total dose of rabbit antithymocyte globulin (r-ATG) (FBx-ATG) results in low incidence of graft-versus-host disease (GVHD) and non-relapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) from HLA-matched related or unrelated donors (MUD). However, whether this platform produces similar results in the setting of one mismatch unrelated donor (MMUD) Allo-HSCT is not known. We retrospectively analyzed patients aged less than 65 years who were diagnosed with hematological malignancies and received FBx-ATG regimen prior to Allo-HSCT from MUD (N = 74) or MMUD (N = 40). We compared outcome of MUD versus MMUD patients. There was no difference in the cumulative incidence of grades II-IV acute GVHD (MUD: 34% vs. MMUD: 35%, P = 0.918), but MMUD patients developed more grade III-IV acute GVHD (MUD: 5% vs. MMUD: 15%, P = 0.016). The cumulative incidences of overall chronic GVHD (MUD: 33% vs. MMUD: 22%, P = 0.088) and extensive chronic GVHD (MUD: 20% vs. MMUD: 19%, P = 0.594) were comparable. One-year NRM was similar in both groups (MUD: 16% vs. MMUD: 14%, P = 0.292); similarly, progression-free survival (MUD: 59% vs. MMUD: 55%, P = 0.476) and overall survival (MUD: 63% vs. MMUD: 61%, P = 0.762) were not different between both groups. With a median follow up of 24 months, 35 of 74 MUD patients (47%) and 19 of 40 MMUD patients (48%) were free of both disease progression and immunosuppressive treatment. We conclude that the FBx-ATG regimen results in low incidences of NRM and GVHD in both MUD and the MMUD recipients. SN - 1096-8652 UR - https://www.unboundmedicine.com/medline/citation/24108528/A_conditioning_platform_based_on_fludarabine_busulfan_and_2_days_of_rabbit_antithymocyte_globulin_results_in_promising_results_in_patients_undergoing_allogeneic_transplantation_from_both_matched_and_mismatched_unrelated_donor_ L2 - https://doi.org/10.1002/ajh.23592 DB - PRIME DP - Unbound Medicine ER -