Alemtuzumab versus anti-thymocyte globulin in patients transplanted from an unrelated donor after a reduced intensity conditioning.

Archive ouverte

Robin, Marie | Raj, Kavita | Chevret, Sylvie | Gauthier, Jordan | de Lavallade, Hugues | Michonneau, David | Mclornan, Donal | Peffault de Latour, Regis | Potter, Victoria | Kulasekararaj, Austin | Sicre de Fontbrune, Flore | Pagliuca, Antonio | Yakoub-Agha, Ibrahim | Socie, Gerard | Mufti Ghulam, J

Edité par CCSD ; Wiley -

International audience. Objective: Relapse and graft-vs-host disease (GVHD) are still the main complications after allogeneic hematopoietic stem cell transplantation, especially in the setting of reduced intensity regimen (RIC) and unrelated donor. We compared here anti-thymocyte globulin (ATG) or alemtuzumab as GVHD prophylaxis in patients with myeloid disease transplanted after RIC and from an unrelated donor.Method: ATG and alemtuzumab patients have been matched by age, gender, HLA matching, comorbidities and cytogenetics risk (119 patients in each group).Results: After matching, we found that ATG decreased the risk of relapse (HR: 0.55, P = .0049) and improved relapse-free survival (RFS, HR: 0.70, P = .042). The improved RFS with ATG was more pronounced in CMV-positive patients but was not influenced by disease risk. Regarding overall survival, GVHD-free relapse-free survival and transplant-related mortality, the risk was similar using ATG or alemtuzumab.Conclusion: Even if GVHD risk is lowered by alemtuzumab use, it does not translate in better outcome due to higher risk of relapse.

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion