Page 148 - 2019_06-Haematologica-web

Ferrata Storti Foundation
Haematologica 2019 Volume 104(6):1230-1236
Stem Cell Transplantation
Antilymphocyte globulin for matched sibling donor transplantation in patients with myelofibrosis
Marie Robin,1 Sylvie Chevret,2 Linda Koster,3 Christine Wolschke,4 Ibrahim Yakoub-Agha,5 Jean Henri Bourhis,6 Patrice Chevallier,7 Jan J. Cornelissen,8 Péter Reményi,9 Johan Maertens,10 Xavier Poiré,11 Charles Craddock,12 Gérard Socié,1 Maija Itälä-Remes,13 Harry C. Schouten,14 Tony Marchand,15 Jakob Passweg,16 Didier Blaise,17 Gandhi Damaj,18 Zubeyde Nur Ozkurt,19 Tsila
20 21 22 Zuckerman, Thomas Cluzeau, Hélène Labussière-Wallet, Jörg
23 24 25 3 Cammenga, Donal McLornan, Yves Chalandon and Nicolaus Kröger
1Hôpital Saint-Louis, APHP, INSERM 1131, Paris, France; 2Service de Biostatistique, Hôpital Saint-Louis, APHP, ESCTRA Team, INSERM UMR1153, Université Paris 7, France; 3EBMT Data Office Leiden, the Netherlands; 4University Hospital Eppendorf, Hamburg, Germany; 5CHU de Lille, LIRIC, INSERM 995, Université de Lille, France; 6Institut Gustave Roussy, INSERM U1186, Université Paris Saclay, Villejuif, France; 7CHU Nantes, France; 8Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands; 9St. István & St. Laszlo Hospital, Budapest, Hungary; 10University Hospital Gasthuisberg, Leuven, Belgium; 11Cliniques Universitaires St. Luc, Brussels, Belgium; 12Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK; 13HUCH Comprehensive Cancer Center, Helsinki, Finland; 14University Hospital Maastricht, the Netherlands; 15Centre Hospitalier Universitaire de Rennes, France; 16University Hospital, Basel, Switzerland; 17Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France; 18CHU Caen, France; 19Gazi University Faculty of Medicine, Ankara, Turkey; 20Rambam Medical Center, Haifa, Israel; 21Université Cote d’Azur, CHU Nice, INSERM U1065, France; 22Centre Hospitalier Lyon Sud, France; 23University Hospital, Linköping, Sweden; 24Comprehensive Cancer Centre, Department of Haematology, King’s College, London, UK and 25Hôpitaux Universitaires de Genève and Faculty of Medicine, University of Geneva, Switzerland
ABSTRACT
The use of antihuman T-lymphocyte immunoglobulin in the setting of transplantation from an HLA-matched related donor is still much debated. Acute and chronic graft-versus-host disease are the main causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation in patients with myelofibrosis. The aim of this study was to evaluate the effect of antihuman T-lymphocyte immunoglobulin in a large cohort of patients with myelofibrosis (n=287). The cumulative incidences of grade II-IV acute graft-versus-host disease among patients who were or were not given antihuman T-lymphocyte immunoglobulin were 26% and 41%, respectively. The corresponding incidences of chronic graft-versus- host disease were 52% and 55%, respectively. Non-adjusted overall sur- vival, disease-free survival and non-relapse mortality rates were 55% versus 53%, 49% versus 45%, and 32% versus 31%, respectively, among the patients who were or were not given antihuman T-lymphocyte immunoglobulin. An adjusted model confirmed that the risk of acute graft- versus-host disease was lower following antihuman T-lymphocyte immunoglobulin (hazard ratio, 0.54; P=0.010) while it did not decrease the risk of chronic graft-versus-host disease. The hazard ratios for overall sur- vival and non-relapse mortality were 0.66 and 0.64, with P-values of 0.05 and 0.09, respectively. Antihuman T-lymphocyte immunoglobulin did not influence disease-free survival, graft-versus-host disease, relapse-free sur- vival or relapse risk. In conclusion, in the setting of matched related trans- plantation in myelofibrosis patients, this study demonstrates that antihu- man T-lymphocyte immunoglobulin decreases the risk of acute graft-versus- host disease without increasing the risk of relapse.
Correspondence:
MARIE ROBIN
marie.robin@aphp.fr
Received: July 11, 2018. Accepted: January 9, 2019. Pre-published: January 17, 2019.
doi:10.3324/haematol.2018.201400
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/104/6/1230
©2019 Ferrata Storti Foundation
Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or inter- nal use. Sharing published material for non-commercial pur- poses is subject to the following conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for com- mercial purposes is not allowed without permission in writing from the publisher.
1230
haematologica | 2019; 104(6)
ARTICLE