Impact of in vivo T-cell depletion in patients with myelodysplastic syndromes undergoing allogeneic hematopoietic stem cell transplant: a registry study from the Chronic Malignancies Working Party of the EBMT.
Alemtuzumab
/ therapeutic use
Graft vs Host Disease
/ etiology
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Myelodysplastic Syndromes
/ complications
Neoplasms
/ complications
Recurrence
Registries
Retrospective Studies
T-Lymphocytes
Transplantation Conditioning
/ adverse effects
Transplantation, Homologous
/ adverse effects
Treatment Outcome
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
09
09
2020
accepted:
14
02
2022
revised:
18
03
2021
pubmed:
28
2
2022
medline:
14
5
2022
entrez:
27
2
2022
Statut:
ppublish
Résumé
While in vivo T-cell depletion (TCD) is widely used, its benefit in patients with MDS still remains a matter of debate. This study evaluates the impact of TCD on outcomes, and compares ATG and alemtuzumab, in patients with MDS. 1284 patients from the EBMT registry were included in this study with 470 patients in the no-TCD group and 814 in the TCD group (alemtuzumab N = 168; ATG N = 646). At 6 months, aGVHD III-IV cumulative incidences (CI) for no-TCD, ATG or alemtuzumab groups were 13% vs 14% vs 11% (ns), respectively. At 5 years, CI of chronic GVHD were 64% vs 52% vs 51% (p < 0.00017); and CI of relapse was 23% vs 25% vs 39% (p < 0.0001) for no TCD, ATG and alemtuzumab respectively; OS was 47% vs 46% vs 34% (p = 0.009) respectively; and GRFS was 21% vs 28% and 20% (p = 0.045) respectively. In multivariable analysis, ATG improved GRFS, and alemtuzumab decreased OS. Both ATG and alemtuzumab decreased risk of chronic GVHD, but the increased risk of relapse with alemtuzumab is associated with a poor GRFS and suggest to not use alemtuzumab in the setting of allo-SCT for high risk disease.
Identifiants
pubmed: 35220412
doi: 10.1038/s41409-022-01620-x
pii: 10.1038/s41409-022-01620-x
doi:
Substances chimiques
Alemtuzumab
3A189DH42V
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
768-774Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Limited.
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