Outcomes of Reduced Intensity Conditioning Allogeneic Hematopoietic Stem Cell Transplantation for Hodgkin Lymphomas: A Retrospective Multicenter Experience by the Rete Ematologica Pugliese (REP)

2019 ◽  
Vol 19 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Francesco Gaudio ◽  
Patrizio Mazza ◽  
Angelo Michele Carella ◽  
Anna Mele ◽  
Giulia Palazzo ◽  
...  
2012 ◽  
Vol 40 (11) ◽  
pp. 892-898 ◽  
Author(s):  
Jury L. Shevchenko ◽  
Alexey N. Kuznetsov ◽  
Tatyana I. Ionova ◽  
Vladimir Y. Melnichenko ◽  
Denis A. Fedorenko ◽  
...  

2016 ◽  
Vol 136 (4) ◽  
pp. 193-200 ◽  
Author(s):  
Jérôme Cornillon ◽  
Marie Balsat ◽  
Aurélie Cabrespine ◽  
Emmanuelle Tavernier-Tardy ◽  
Eric Hermet ◽  
...  

Reduced intensity conditioning for allogeneic hematopoietic stem cell transplantation (allo-HSCT) is often proposed for patients with comorbidities. To enhance engraftment and limit graft-versus-host disease (GVHD), antithymoglobulin (ATG) is usually used. However, the dose needed remains unclear unlike myeloablative conditioning. In order to clarify this point, we conducted a retrospective study on patients who received a reduced intensity conditioning allo-HSCT based on a 2-day fludarabine and busulfan treatment with either 1 or 2 days of ATG treatment. One hundred and eight patients received 2.5 mg/kg (ATG2.5) and another 60 patients 5 mg/kg (ATG5). The median follow-up was 36 months. The median overall survival was 39 months and the median disease-free survival 45 months. In multivariate analysis, overall nonrelapse mortality (NRM) was independently influenced by the acute GVHD grade III-IV (p < 0.001) and ATG dose (30 vs. 21% for ATG5; p = 0.008). Despite heterogeneity of populations, using proportional-hazard assumptions, we have been able to observe in multivariate analysis a lower NRM in the ATG5 group. This leads to a statistically higher overall survival for the ATG5 group. In conclusion, 2 days of ATG decrease NRM independently without increasing the risk of relapse or infectious disease.


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