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Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant.
Exp Clin Transplant. 2015 Oct; 13(5):453-60.EC

Abstract

OBJECTIVES

Sparse data are available about the effects of apheretic graft composition on the clinical transplant outcome in allotransplanted patients who have hematologic malignant disease. Major obstacles in recent studies have included heterogeneity of patient populations and differences in the conditioning regimens used.

MATERIALS AND METHODS

This prospective study included 50 patients who had acute myeloblastic leukemia and received busulfan-fludarabine-antithymocyte globulin-based conditioning for peripheral allogeneic stem cell transplant. The concentration of CD34+ cells, T-cell subsets, B cells, and natural killer cells in the graft were analyzed by flow cytometry in the donors who were matched for human leukocyte antigen.

RESULTS

In univariate analysis, infusion with a higher dose of natural killer cells (> 1.55 × 106/kg) was associated with improved survival (P = .007 for disease-free survival; P = .024 for overall survival) in patients with acute myeloblastic leukemia. Cox regression models revealed that increased concentration of natural killer cells and CD34+ cells positively affected the clinical outcome of allotransplanted patients (P = .005 for both cell types). According to univariate analysis, these findings were dependent on minimal residual disease and acute graft-versus-host disease. Graft-versus-host disease (acute and chronic forms) was not affected by graft composition.

CONCLUSIONS

Our results suggest that increased concentration of natural killer cells and CD34+ cells in the apheretic product may predict better survival. In contrast, busulfan-fludarabine-antithymocyte globulin-based conditioning eliminates the disadvantages that resulted from the high content of T-cell subsets and B cells, and the course of the transplant and clinical parameters were not affected by the amount of T and B cells.

Authors+Show Affiliations

Baskent University Adana Adult Bone Marrow Transplantation Center, Adana, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26103468

Citation

Yeral, Mahmut, et al. "Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant." Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, vol. 13, no. 5, 2015, pp. 453-60.
Yeral M, Kasar M, Boga C, et al. Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant. Exp Clin Transplant. 2015;13(5):453-60.
Yeral, M., Kasar, M., Boga, C., Kozanoglu, I., Ozdogu, H., & Sariturk, C. (2015). Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant. Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, 13(5), 453-60. https://doi.org/10.6002/ect.2014.0223
Yeral M, et al. Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant. Exp Clin Transplant. 2015;13(5):453-60. PubMed PMID: 26103468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Relevance of Apheretic Graft Composition in Patients With Acute Myeloblastic Leukemia Who Received a Busulfan-Fludarabine-Antithymocyte Globulin Conditioning Regimen for Allogeneic Transplant. AU - Yeral,Mahmut, AU - Kasar,Mutlu, AU - Boga,Can, AU - Kozanoglu,Ilknur, AU - Ozdogu,Hakan, AU - Sariturk,Cagla, Y1 - 2015/06/15/ PY - 2015/6/24/entrez PY - 2015/6/24/pubmed PY - 2016/7/28/medline SP - 453 EP - 60 JF - Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation JO - Exp Clin Transplant VL - 13 IS - 5 N2 - OBJECTIVES: Sparse data are available about the effects of apheretic graft composition on the clinical transplant outcome in allotransplanted patients who have hematologic malignant disease. Major obstacles in recent studies have included heterogeneity of patient populations and differences in the conditioning regimens used. MATERIALS AND METHODS: This prospective study included 50 patients who had acute myeloblastic leukemia and received busulfan-fludarabine-antithymocyte globulin-based conditioning for peripheral allogeneic stem cell transplant. The concentration of CD34+ cells, T-cell subsets, B cells, and natural killer cells in the graft were analyzed by flow cytometry in the donors who were matched for human leukocyte antigen. RESULTS: In univariate analysis, infusion with a higher dose of natural killer cells (> 1.55 × 106/kg) was associated with improved survival (P = .007 for disease-free survival; P = .024 for overall survival) in patients with acute myeloblastic leukemia. Cox regression models revealed that increased concentration of natural killer cells and CD34+ cells positively affected the clinical outcome of allotransplanted patients (P = .005 for both cell types). According to univariate analysis, these findings were dependent on minimal residual disease and acute graft-versus-host disease. Graft-versus-host disease (acute and chronic forms) was not affected by graft composition. CONCLUSIONS: Our results suggest that increased concentration of natural killer cells and CD34+ cells in the apheretic product may predict better survival. In contrast, busulfan-fludarabine-antithymocyte globulin-based conditioning eliminates the disadvantages that resulted from the high content of T-cell subsets and B cells, and the course of the transplant and clinical parameters were not affected by the amount of T and B cells. SN - 2146-8427 UR - https://www.unboundmedicine.com/medline/citation/26103468/Clinical_Relevance_of_Apheretic_Graft_Composition_in_Patients_With_Acute_Myeloblastic_Leukemia_Who_Received_a_Busulfan_Fludarabine_Antithymocyte_Globulin_Conditioning_Regimen_for_Allogeneic_Transplant_ L2 - http://www.ectrx.org/forms/ectrxcontentshow.php?year=2015&volume=13&issue=5&supplement=0&makale_no=0&spage_number=453&content_type=FULL TEXT DB - PRIME DP - Unbound Medicine ER -