Anti-T-lymphocyte globulin (ATLG) compared to post-transplant cyclophosphamide as GvHD prophylaxis in ALL patients undergoing allogeneic stem cell transplantation-Reference-Cited by-同舟云学术

Anti-T-lymphocyte globulin (ATLG) compared to post-transplant cyclophosphamide as GvHD prophylaxis in ALL patients undergoing allogeneic stem cell transplantation

Published:2024-06-14 Issue:9 Volume:59 Page:1265-1274
ISSN:0268-3369
Container-title:Bone Marrow Transplantation
language:en
Short-container-title:Bone Marrow Transplant

Author:

Steiner Normann^ORCID,Massoud Radwan,Klyuchnikov Evgeny,Gagelmann Nico,Richter Johanna,Niederwieser Christian^ORCID,Rathje Kristin,Urbanowicz Tatjana,Kunte Ameya,Engelmann Janik,Ihne Christina,Lastovytska Iryna,Lindhauer Cecilia,Marquard Franziska,Reichard Mirjam,Ryzhkova Alla,Sabauri Rusudan,Schäfersküpper Mathias,Seyedi Niloufar,Kalogeropoulos Georgios,Heidenreich Silke,Rudolph Ina,Zeck Gaby,Janson Dietlinde,Wolschke Christine,Ayuk Francis^ORCID,Kröger Nicolaus^ORCID

Abstract

AbstractWe retrospectively analyzed high-risk ALL patients in CR1 receiving total body irradiation based conditioning regimen with ATLG (n = 74) or PTCy (n = 73) for GVHD prophylaxis. The 3-year OS and LFS were similar in both groups: 65 and 60% in the ATLG group and 64 and 67% in the PTCy group (p = 0.9 and 0.5, respectively). CIR and NRM rate at three years was 12 and 21% after PTCy and 19 and 20% after ATLG (p = 0.4 and p = 0.9, respectively). Acute GvHD grades II-IV and grades III/IV at 100 days was 46 and 19% after PTCy and 33 and 10% after ATLG (p = 0.08 and p = 0.9, respectively). Chronic GvHD of all grade at two years was higher after PTCy: 55% versus 26% (p < 0.001). Based on the propensity score matching (PSM) analysis, aGvHD grades II-IV was trending higher in the PTCy group compared to the ATLG group (p = 0.07). In contrast to the PSM analysis, on multivariate analysis the receipt of PTCy compared with ATLG was associated with a reduced CIR (p = 0.026). Our retrospective single-center analysis shows a lower incidence of acute and chronic GvHD while displaying similar LFS and OS after ATLG compared to PTCy in TBI based allogeneic stem cell transplantation for high-risk ALL.

Publisher

Springer Science and Business Media LLC

Link

https://www.nature.com/articles/s41409-024-02328-w.pdf

Reference52 articles.

1. Hoelzer D, Bassan R, Dombret H, Fielding A, Ribera JM, Buske C, et al. Acute lymphoblastic leukaemia in adult patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27:v69–v82. https://doi.org/10.1093/annonc/mdw025.

2. Giebel S, Marks DI, Boissel N, Baron F, Chiaretti S, Ciceri F, et al. Hematopoietic stem cell transplantation for adults with Philadelphia chromosome-negative acute lymphoblastic leukemia in first remission: a position statement of the European Working Group for Adult Acute Lymphoblastic Leukemia (EWALL) and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transpl. 2019;54:798–809. https://doi.org/10.1038/s41409-018-0373-4.

3. Giebel S, Labopin M, Socié G, Beelen D, Browne P, Volin L, et al. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2017;102:139–49. https://doi.org/10.3324/haematol.2016.145631.

4. Marks DI, Forman SJ, Blume KG, Pérez WS, Weisdorf DJ, Keating A, et al. A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission. Biol Blood Marrow Transpl. 2006;12:438–53. https://doi.org/10.1016/j.bbmt.2005.12.029.

5. Cahu X, Labopin M, Giebel S, Aljurf M, Kyrcz-Krzemien S, Socié G, et al. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transpl. 2016;51:351–7. https://doi.org/10.1038/bmt.2015.278.