SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on March 20, 2003; DOI 10.1182/blood-2002-12-3629. This Article Full Text (PDF) All Versions of this Article: 2002-12-3629v1 102/2/470    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mohty, M. Articles by Blaise, D. Search for Related Content PubMed PubMed Citation Articles by Mohty, M. Articles by Blaise, D. Social Bookmarking                   What's this? Submitted December 2, 2002 Accepted March 17, 2003 Graft-versus-host disease following allogeneic HLA-identical sibling transplantation with anti-thymocyte globulin-based reduced intensity preparative regimen Mohamad Mohty, Jacques-Olivier Bay, Catherine Faucher, Bachra Choufi, Karin Bilger, Olivier Tournilhac, Norbert Vey, Anne-Marie Stoppa, Diane Coso, Christian Chabannon, Patrice Viens, Dominique Maraninchi, and Didier Blaise* Institut Paoli-Calmettes, Marseille, France Centre Jean-Perrin, Clermont-Ferrand, France * Corresponding author; email: mohtym{at}marseille.fnclcc.fr. Reduced intensity conditioning regimens (RIC) are increasingly used for allogeneic stem cell transplantation (allo-SCT). RIC has been shown to allow engraftment with minimal early transplant-related mortality (TRM). However, in the context of RIC, predictive factors for acute and chronic graft-versus-host disease (aGVHD, cGVHD) and their impact on outcome remain unknown. In this report, we analyzed the outcome of 101 high risk patients (70 hematological and 31 non-hematological malignancies) who received an HLA-identical sibling allo-SCT after RIC including fludarabine, busulfan and anti-thymocyte globulin (ATG). The cumulative incidence of grade II-IV aGVHD was 36% (95% CI, 27%-45%) while the cumulative incidence of cGVHD at 2 years was 43% (95% CI, 33%-53%). In multivariate analysis, the incidence of aGVHD was significantly associated with the ATG dose infused during conditioning (P= .0005), while peripheral blood as stem cell source was the only predictive factor for the development of cGVHD (P= .0007). The 1-year cumulative incidences of disease progression or relapse in patients with (n = 69) and without (n = 31) GVHD (whatever its form or grade) were 30% (95% CI, 19%-41%) and 55% (95% CI, 37%-72%), respectively (P= .02), suggesting that a potent graft-versus-tumor (GVT) effect can be achieved in high risk patients following RIC. Moreover, the GVT effect was closely associated with GVHD without an increased risk of TRM [cumulative incidence of TRM, 18% (95% CI, 10%-25%)]. Collectively, these results provide a framework for the refinement of RIC approaches designed to enhance the GVT effect with an acceptable risk of GVHD. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Mohty, M. Labopin, R. Tabrizzi, N. Theorin, A. A Fauser, A. Rambaldi, J. Maertens, S. Slavin, I. Majolino, A. Nagler, et al. Reduced intensity conditioning allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation Haematologica, February 1, 2008; 93(2): 303 - 306. [Abstract] [Full Text] [PDF] M. Mohty, O. Avinens, C. Faucher, P. Viens, D. Blaise, and J.-F. Eliaou Predictive factors and impact of full donor T-cell chimerism after reduced intensity conditioning allogeneic stem cell transplantation Haematologica, July 1, 2007; 92(7): 1004 - 1006. [Abstract] [Full Text] [PDF] D. Blaise, N. Vey, C. Faucher, and M. Mohty Current status of reduced intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia Haematologica, April 1, 2007; 92(4): 533 - 541. [Abstract] [Full Text] [PDF] F. Baron, R. Storb, B. E. Storer, M. B. Maris, D. Niederwieser, J. A. Shizuru, T. R. Chauncey, B. Bruno, S. J. Forman, P. A. McSweeney, et al. Factors Associated With Outcomes in Allogeneic Hematopoietic Cell Transplantation With Nonmyeloablative Conditioning After Failed Myeloablative Hematopoietic Cell Transplantation J. Clin. Oncol., September 1, 2006; 24(25): 4150 - 4157. [Abstract] [Full Text] [PDF] R. Martino, S. Iacobelli, R. Brand, T. Jansen, A. van Biezen, J. Finke, A. Bacigalupo, D. Beelen, J. Reiffers, A. Devergie, et al. Retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic hematopoietic stem cell transplantation using HLA-identical sibling donors in myelodysplastic syndromes Blood, August 1, 2006; 108(3): 836 - 846. [Abstract] [Full Text] [PDF] B. L. Scott and B. M. Sandmaier Outcomes with Myeloid Malignancies Hematology, January 1, 2006; 2006(1): 381 - 389. [Abstract] [Full Text] [PDF] M. Mohty, D. Blaise, C. Faucher, N. Vey, R. Bouabdallah, A.-M. Stoppa, F. Viret, G. Gravis, D. Olive, and B. Gaugler Inflammatory cytokines and acute graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation Blood, December 15, 2005; 106(13): 4407 - 4411. [Abstract] [Full Text] [PDF] D. Blaise, J. O. Bay, C. Faucher, M. Michallet, J.-M. Boiron, B. Choufi, J.-Y. Cahn, N. Gratecos, J.-J. Sotto, S. Francois, et al. Reduced-intensity preparative regimen and allogeneic stem cell transplantation for advanced solid tumors Blood, January 15, 2004; 103(2): 435 - 441. [Abstract] [Full Text] [PDF]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020