Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia: A study on behalf of the European blood and marrow transplant severe aplastic anemia working party

Severe Aplastic Anaemia Working Party of the EBMT

doi:10.1002/ajh.25314

Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia: A study on behalf of the European blood and marrow transplant severe aplastic anemia working party

Severe Aplastic Anaemia Working Party of the EBMT

Department of Clinical Medicine

9 Citations (Scopus)

Abstract

We retrospectively analyzed the outcomes of 1837 adults and children with severe aplastic anemia (SAA) who underwent matched sibling donor (MSD) and matched unrelated donor (MUD) hemopoietic stem cell transplantation (HSCT) between 2000 and 2013. Patients were grouped by transplant conditioning containing either anti-thymocyte globulin (ATG) (n = 1283), alemtuzumab (n = 261), or no serotherapy (NS) (n = 293). The risks of chronic GvHD were significantly reduced when ATG or alemtuzumab were compared with NS (P = .021 and .003, respectively). Acute GVHD was significantly reduced in favor of alemtuzumab compared with ATG (P = .012) and NS (P < .001). By multivariate analysis, when compared with ATG, alemtuzumab was associated with a lower risk of developing acute (OR 0.262; 95% CI 0.14-0.47; P < .001) and chronic GVHD (HR 0.58; 95% CI 0.35-0.94; P = .027). OS was significantly better in ATG and alemtuzumab patients compared with NS (P = .010 and .025). Our data shows inclusion of serotherapy in MSD and MUD HSCT for patients with SAA reduces chronic GVHD and provides a survival advantage over patients not receiving serotherapy. Notably, alemtuzumab reduced the risk of acute and chronic GvHD compared with ATG and indicates that alemtuzumab might be the serotherapy of choice for MSD and MUD transplants for SAA.

Original language	English
Journal	American Journal of Hematology
Volume	94
Issue number	1
Pages (from-to)	80-86
Number of pages	7
ISSN	0361-8609
DOIs	https://doi.org/10.1002/ajh.25314
Publication status	Published - Jan 2019

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Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia : A study on behalf of the European blood and marrow transplant severe aplastic anemia working party. / Severe Aplastic Anaemia Working Party of the EBMT.

In: American Journal of Hematology, Vol. 94, No. 1, 01.2019, p. 80-86.

Research output: Contribution to journal › Journal article › Research › peer-review

Severe Aplastic Anaemia Working Party of the EBMT 2019, 'Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia: A study on behalf of the European blood and marrow transplant severe aplastic anemia working party', American Journal of Hematology, vol. 94, no. 1, pp. 80-86. https://doi.org/10.1002/ajh.25314

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title = "Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia: A study on behalf of the European blood and marrow transplant severe aplastic anemia working party",

abstract = "We retrospectively analyzed the outcomes of 1837 adults and children with severe aplastic anemia (SAA) who underwent matched sibling donor (MSD) and matched unrelated donor (MUD) hemopoietic stem cell transplantation (HSCT) between 2000 and 2013. Patients were grouped by transplant conditioning containing either anti-thymocyte globulin (ATG) (n = 1283), alemtuzumab (n = 261), or no serotherapy (NS) (n = 293). The risks of chronic GvHD were significantly reduced when ATG or alemtuzumab were compared with NS (P = .021 and .003, respectively). Acute GVHD was significantly reduced in favor of alemtuzumab compared with ATG (P = .012) and NS (P < .001). By multivariate analysis, when compared with ATG, alemtuzumab was associated with a lower risk of developing acute (OR 0.262; 95% CI 0.14-0.47; P < .001) and chronic GVHD (HR 0.58; 95% CI 0.35-0.94; P = .027). OS was significantly better in ATG and alemtuzumab patients compared with NS (P = .010 and .025). Our data shows inclusion of serotherapy in MSD and MUD HSCT for patients with SAA reduces chronic GVHD and provides a survival advantage over patients not receiving serotherapy. Notably, alemtuzumab reduced the risk of acute and chronic GvHD compared with ATG and indicates that alemtuzumab might be the serotherapy of choice for MSD and MUD transplants for SAA.",

author = "Sujith Samarasinghe and Katherine Clesham and Simona Iacobelli and Giulia Sbianchi and Cora Knol and Rose-Marie Hamladji and Gerard Soci{\'e} and Mahmoud Aljurf and Mickey Koh and Henrik Sengeloev and Jean-Hugues Dalle and Stephen Robinson and {Van Lint}, {Maria Teresa} and Halkes, {Constantijn J M} and Dietrich Beelen and Mufti, {Ghulam J} and John Snowden and Didier Blaise and {de Latour}, {Regis Peffault} and Judith Marsh and Carlo Dufour and Risitano, {Antonio M} and {Severe Aplastic Anaemia Working Party of the EBMT}",

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T1 - Impact of T-cell depletion strategies on outcomes following hematopoietic stem cell transplantation for idiopathic aplastic anemia

T2 - A study on behalf of the European blood and marrow transplant severe aplastic anemia working party

AU - Samarasinghe, Sujith

AU - Clesham, Katherine

AU - Iacobelli, Simona

AU - Sbianchi, Giulia

AU - Knol, Cora

AU - Hamladji, Rose-Marie

AU - Socié, Gerard

AU - Aljurf, Mahmoud

AU - Koh, Mickey

AU - Sengeloev, Henrik

AU - Dalle, Jean-Hugues

AU - Robinson, Stephen

AU - Van Lint, Maria Teresa

AU - Halkes, Constantijn J M

AU - Beelen, Dietrich

AU - Mufti, Ghulam J

AU - Snowden, John

AU - Blaise, Didier

AU - de Latour, Regis Peffault

AU - Marsh, Judith

AU - Dufour, Carlo

AU - Risitano, Antonio M

AU - Severe Aplastic Anaemia Working Party of the EBMT

PY - 2019/1

Y1 - 2019/1

N2 - We retrospectively analyzed the outcomes of 1837 adults and children with severe aplastic anemia (SAA) who underwent matched sibling donor (MSD) and matched unrelated donor (MUD) hemopoietic stem cell transplantation (HSCT) between 2000 and 2013. Patients were grouped by transplant conditioning containing either anti-thymocyte globulin (ATG) (n = 1283), alemtuzumab (n = 261), or no serotherapy (NS) (n = 293). The risks of chronic GvHD were significantly reduced when ATG or alemtuzumab were compared with NS (P = .021 and .003, respectively). Acute GVHD was significantly reduced in favor of alemtuzumab compared with ATG (P = .012) and NS (P < .001). By multivariate analysis, when compared with ATG, alemtuzumab was associated with a lower risk of developing acute (OR 0.262; 95% CI 0.14-0.47; P < .001) and chronic GVHD (HR 0.58; 95% CI 0.35-0.94; P = .027). OS was significantly better in ATG and alemtuzumab patients compared with NS (P = .010 and .025). Our data shows inclusion of serotherapy in MSD and MUD HSCT for patients with SAA reduces chronic GVHD and provides a survival advantage over patients not receiving serotherapy. Notably, alemtuzumab reduced the risk of acute and chronic GvHD compared with ATG and indicates that alemtuzumab might be the serotherapy of choice for MSD and MUD transplants for SAA.

AB - We retrospectively analyzed the outcomes of 1837 adults and children with severe aplastic anemia (SAA) who underwent matched sibling donor (MSD) and matched unrelated donor (MUD) hemopoietic stem cell transplantation (HSCT) between 2000 and 2013. Patients were grouped by transplant conditioning containing either anti-thymocyte globulin (ATG) (n = 1283), alemtuzumab (n = 261), or no serotherapy (NS) (n = 293). The risks of chronic GvHD were significantly reduced when ATG or alemtuzumab were compared with NS (P = .021 and .003, respectively). Acute GVHD was significantly reduced in favor of alemtuzumab compared with ATG (P = .012) and NS (P < .001). By multivariate analysis, when compared with ATG, alemtuzumab was associated with a lower risk of developing acute (OR 0.262; 95% CI 0.14-0.47; P < .001) and chronic GVHD (HR 0.58; 95% CI 0.35-0.94; P = .027). OS was significantly better in ATG and alemtuzumab patients compared with NS (P = .010 and .025). Our data shows inclusion of serotherapy in MSD and MUD HSCT for patients with SAA reduces chronic GVHD and provides a survival advantage over patients not receiving serotherapy. Notably, alemtuzumab reduced the risk of acute and chronic GvHD compared with ATG and indicates that alemtuzumab might be the serotherapy of choice for MSD and MUD transplants for SAA.

U2 - 10.1002/ajh.25314

DO - 10.1002/ajh.25314

M3 - Journal article

C2 - 30328134

SN - 0361-8609

VL - 94

SP - 80

EP - 86

JO - American Journal of Hematology

JF - American Journal of Hematology

IS - 1

ER -