Cyclophosphamide and horse anti-thymocyte globulin versus fludarabine, reduced cyclophosphamide and rabbit anti-thymocyte globulin conditioning regimen for allogeneic hematopoietic stem cell transplantation from matched sibling donors in patients with acquired aplastic anemia

被引：0
作者：
Ben Abdeljelil, Nour [1 ]
Ben Yaiche, Insaf [1 ]
Ouerghi, Rihab [1 ]
Torjemane, Lamia [1 ]
Belloumi, Dorra [1 ]
Turki, Ines [1 ]
Mekni, Sabrine [1 ]
Kanoun, Rimel Yousr [1 ]
Ben Othman, Tarek [1 ]
Ladeb, Saloua [1 ]
机构：
[1] Univ Tunis El Manar Tunis, Ctr Natl Greffe Moelle Osseuse, Tunis, Tunisia
来源：
EXPERT REVIEW OF HEMATOLOGY | 2024年 / 17卷 / 08期
关键词：
Aplastic anemia; conditioning regimen; allogeneic hematopoietic stem cell transplantation; graft failure; survival; BONE-MARROW-TRANSPLANTATION; VERSUS-HOST-DISEASE; GRAFT-REJECTION; ANTITHYMOCYTE GLOBULIN; ADULT PATIENTS; EUROPEAN GROUP; FAILURE; CHIMERISM; BLOOD; SURVIVAL;
D O I：
10.1080/17474086.2024.2381572
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
BackgroundAllogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acquired aplastic anemia (acquired AA) in young patients. The objective of the study was to compare patient outcomes after Cyclophosphamide and horse antithymocyte globulin (Cy-hATG) versus Fludarabine-cyclophosphamide and rabbit ATG (Flu-Cy-rATG) as part of conditioning regimen in allo-HSCT for acquired AA.Research design and methodsDescriptive retrospective study conducted on patients with acquired AA who received allo-HSCT from HLA-matched sibling donors between January 2008 and August 2022 after conditioning regimen with Cy-hATG or Flu-Cy-rATG.ResultsA total of 121 patients were enrolled. Cumulative incidence of graft failure was 11.2% in Cy-hATG and 5.3% Flu-Cy-rATG group. There were no significant differences between the two groups in terms of acute GVHD, chronic GVHD, and transplant related mortality. Flu-Cy-rATG group was associated with significantly higher CMV and EBV reactivation(s) compared to Cy-hATG group (p = 0.008 and 0.035, respectively). After a median follow-up of 58 months, estimated overall survival, event-free survival, and graft rejection-free survival were not statistically different between the two groups.ConclusionsIn high-risk population, Flu-Cy-rATG is associated with comparable outcomes to Cy-hATG in allo-HSCT from MSD. However, it seems to be associated with significant risk of viral infections.
引用
收藏
页码：527 / 538
页数：12
相关论文
共 47 条
[1]  
Abdelkefi Abderrahman, 2003, Hematol J, V4, P208, DOI 10.1038/sj.thj.6200246
[2]   Long-term outcome after bone marrow transplantation for severe aplastic anemia [J].
Ades, L ;
Mary, JY ;
Robin, M ;
Ferry, C ;
Porcher, R ;
Esperou, H ;
Ribaud, P ;
Devergie, A ;
Traineau, R ;
Gluckman, E ;
Socié, G .
BLOOD, 2004, 103 (07) :2490-2497
[3]   Allogeneic stem cell transplantation for severe aplastic anemia: Graft rejection remains a problem [J].
Aki, Sahika Zeynep ;
Sucak, Gulsan Turkoz ;
Oezkurt, Zubeyde Nur ;
Yegin, Zeynep Arzu ;
Yagci, Munci ;
Haznedar, Rauf .
TRANSFUSION AND APHERESIS SCIENCE, 2009, 40 (01) :5-11
[4]   Fludarabine-Based Conditioning Chemotherapy for Allogeneic Hematopoietic Stem Cell Transplantation in Acquired Severe Aplastic Anemia [J].
Al-Zahrani, Hazzaa ;
Nassar, Amr ;
Al-Mohareb, Fahad ;
Al-Sharif, Fahad ;
Mohamed, Said ;
Al-Anazi, Khalid ;
Patel, Moosa ;
Rasheed, Walid ;
Saleh, Abu Jafar Mohammed ;
Bakr, Mahmoud ;
Ahmed, Shad ;
Ibrahim, Khalid ;
Hussain, Fazal ;
Elkum, Naser ;
Elhassan, Tusneem ;
Nurgat, Zubeir ;
Chaudhri, Naeem ;
Aljurf, Mahmoud .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2011, 17 (05) :717-722
[5]   Standard treatment of acquired SAA in adult patients 18-40 years old with an HLA-identical sibling donor [J].
Aljurf, M. ;
Al-Zahrani, H. ;
Van Lint, M. T. ;
Passweg, J. R. .
BONE MARROW TRANSPLANTATION, 2013, 48 (02) :178-179
[6]   Establishment of complete and mixed donor chimerism after allogeneic lymphohematopoietic transplantation: Recommendations from a Workshop at the 2001 Tandem Meetings [J].
Antin, JH ;
Childs, R ;
Filipovich, AH ;
Giralt, S ;
Mackinnon, S ;
Spitzer, T ;
Weisdorf, D .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2001, 7 (09) :473-485
[7]   Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease [J].
Atsuta, Y. ;
Suzuki, R. ;
Yamashita, T. ;
Fukuda, T. ;
Miyamura, K. ;
Taniguchi, S. ;
Iida, H. ;
Uchida, T. ;
Ikegame, K. ;
Takahashi, S. ;
Kato, K. ;
Kawa, K. ;
Nagamura-Inoue, T. ;
Morishima, Y. ;
Sakamaki, H. ;
Kodera, Y. .
ANNALS OF ONCOLOGY, 2014, 25 (02) :435-441
[8]  
Bacigalupo A, 2000, SEMIN HEMATOL, V37, P69, DOI 10.1016/S0037-1963(00)90031-3
[9]   Current outcome of HLA identical sibling versus unrelated donor transplants in severe aplastic anemia: an EBMT analysis [J].
Bacigalupo, Andrea ;
Socie, Gerard ;
Hamladji, Rose Marie ;
Aljurf, Mahmoud ;
Maschan, Alexei ;
Kyrcz-Krzemien, Slawomira ;
Chybicka, Alicja ;
Sengelov, Henrik ;
Unal, Ali ;
Beelen, Dietrich ;
Locasciulli, Anna ;
Dufour, Carlo ;
Passweg, Jakob R. ;
Oneto, Rosi ;
Signori, Alessio ;
Marsh, Judith C. W. .
HAEMATOLOGICA, 2015, 100 (05) :696-702
[10]   Bone marrow versus peripheral blood as the stem cell source for sibling transplants in acquired aplastic anemia: survival advantage for bone marrow in all age groups [J].
Bacigalupo, Andrea ;
Socie, Gerard ;
Schrezenmeier, Hubert ;
Tichelli, Andre ;
Locasciulli, Anna ;
Fuehrer, Monika ;
Risitano, Antonio M. ;
Dufour, Carlo ;
Passweg, Jakob R. ;
Oneto, Rosi ;
Aljurf, Mahmoud ;
Flynn, Catherine ;
Mialou, Valerie ;
Hamladji, Rose Marie ;
Marsh, Judith C. W. .
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2012, 97 (08) :1142-1148
12345