Allogeneic peripheral blood stem cell transplantation with anti-thymocyte globulin versus allogeneic bone marrow transplantation without anti-thymocyte globulin
Frédéric Baron,
Jacques-Emmanue Galimard,
Myriam Labopin,
Ibrahim Yakoub-Agha,
Riitta Niittyvuopio,
Nicolaus Kröger,
Laimonas Griskevicius,
Depei Wu,
Edouard Forcade,
Carlos Richard,
Mahmoud Aljurf,
Grzegorz Helbig,
Hélène Labussière-Wallet,
Mohamad Mohty,
Arnon Nagler
Affiliations
Frédéric Baron
Laborator y of Hematology, GIGA -I3, University of Liege and CHU of Liège, Liège, Belgium
Jacques-Emmanue Galimard
EBMT Paris study of fice/CEREST-TC, Paris, France;Department of Haematology, Saint Antoine Hospital, Paris, France;Sorbonne University, Centre De Recherche Saint Antoine, INSERM UMR938, Paris, France;Sorbonne University, Paris, France
Myriam Labopin
EBMT Paris study of fice/CEREST-TC, Paris, France;Department of Haematology, Saint Antoine Hospital, Paris, France;Sorbonne University, Centre De Recherche Saint Antoine, INSERM UMR938, Paris, France;Sorbonne University, Paris, France
Ibrahim Yakoub-Agha
University of Lille, INSERM, and CHU of Lille, INFINITE U1286, Lille, France
Riitta Niittyvuopio
HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
Nicolaus Kröger
University Hospital Eppendorf, Bone Marrow Transplantation Center, Hamburg, Germany
Laimonas Griskevicius
Institute of Clinical Medicine, Vilnius University and Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
Depei Wu
First Affiliated Hospital of Soochow University, Department of Hematology, Suzhou, China
Edouard Forcade
CHU Bordeaux Hôpital Haut-Leveque, Pessac, France
Carlos Richard
Hospital U. Marqués de Valdecilla, Servicio de Hematología-IDIVAL, Santander, Spain
Mahmoud Aljurf
King Faisal Specialist Hospital & Research Centre Oncology, Riyadh, Saudi Arabia
Grzegorz Helbig
Silesian Medical Academy, University Department of Haematology and Bone Marrow Transplantation, Katowice, Poland
Hélène Labussière-Wallet
Centre Hospitalier Lyon Sud, Service Hematologie, Lyon, France
Mohamad Mohty
EBMT Paris study of fice/CEREST-TC, Paris, France;Department of Haematology, Saint Antoine Hospital, Paris, France;Sorbonne University, Centre De Recherche Saint Antoine, INSERM UMR938, Paris, France;Sorbonne University, Paris, France
Arnon Nagler
EBMT Paris study of fice/CEREST-TC, Paris, France;Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
We compared severe graft-versus-host-disease (GvHD) free and relapse-free survival and other transplantation outcomes of acute myeloid leukemia (AML) patients given bone marrow (BM) without anti-thymocyte globulin (ATG) versus peripheral blood stem cells (PBSC) with ATG after myeloablative conditioning. In the cohort of patients receiving grafts from a human leukocyte antigen (HLA)-matched sibling donor, patients given PBSC with ATG (n=1,021) and those given BM without ATG (n=1,633) presented comparable severe GvHD-free relapse-free survival (GRSF)(hazard ratio [HR]=0.9, 95% confidence interval [CI]: 0.8-1.1, P=0.5) and overall survival (HR=1.0, 95% CI: 0.8-1.2, P=0.8). They had however, a lower incidence of chronic GvHD (cGvHD) (HR=0.7, 95% CI: 0.6-0.9, P=0.01). In the cohort of patients receiving grafts from HLA-matched unrelated donor , patients given PBSC with ATG (n=2,318) had better severe GvHD-free and relapse-free survival (GRFS) than those given BM without ATG (n=303) (HR=0.8, 95% CI: 0.6-0.9, P=0.001). They also had a lower incidence of cGvHD (HR=0.6, 95% CI: 0.5-0.8, P=0.0006) and better overall survival (HR=0.8, 95% CI: 0.6-1.0, P=0.04). In summary, these data suggest that PBSC with ATG results in comparable (in the case of sibling donor) or significantly better (in the case of unrelated donor) severe GRFS than BM without ATG in patients with AML in complete remission receiving grafts after myeloablative conditioning.
