Reduced incidence of GVHD without increase in relapse with low-dose rabbit ATG in the preparative regimen for unrelated bone marrow transplants in CML
Antithymocyte globulin (ATG) treatment prevents graft failure and results in a low incidence of GVHD, but an increased risk of relapse could be expected as a consequence of reduced GVHD. From September 1995 to June 2001, 28 consecutive chronic myeloid leukemia (CML) patients underwent unrelated bone...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2003-08, Vol.32 (3), p.237-242 |
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| creator | BONIFAZI, F BANDINI, G BACCARANI, M RONDELLI, D FALCIONI, S STANZANI, M BONTADINI, A TAZZARI, P. L ARPINATI, M GIANNINI, B CONTE, R |
| description | Antithymocyte globulin (ATG) treatment prevents graft failure and results in a low incidence of GVHD, but an increased risk of relapse could be expected as a consequence of reduced GVHD. From September 1995 to June 2001, 28 consecutive chronic myeloid leukemia (CML) patients underwent unrelated bone marrow transplants: 21 were in chronic phase (CP) and seven in advanced phase (AP). Median age was 35.5 years (range 20-50). HLA typing was based on high-resolution molecular techniques; in eight cases there were one or more allele mismatches. The preparative regimen consisted of TBI, EDX 120 mg/kg and rabbit ATG 15 mg/kg. All patients engrafted and no rejection occurred. Acute GVHD grade III-IV occurred in six patients (21%). Chronic GVHD occurred in 10 (40%) and it was extensive in one. Four out of seven patients transplanted in AP had a hematological relapse. Of 21 in CP, there was one cytogenetic and one molecular relapse: these two patients are now in complete remission with imatinib mesylate. With a median follow-up of 45.7 months, the 5-year survival is 76.2% for those transplanted in CP. These data demonstrate that transplants performed in CP, with low-dose ATG, are associated with a good outcome, low incidence of GVHD and no increase of relapse. |
| doi_str_mv | 10.1038/sj.bmt.1704138 |
| format | Article |
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L ; ARPINATI, M ; GIANNINI, B ; CONTE, R</creator><creatorcontrib>BONIFAZI, F ; BANDINI, G ; BACCARANI, M ; RONDELLI, D ; FALCIONI, S ; STANZANI, M ; BONTADINI, A ; TAZZARI, P. L ; ARPINATI, M ; GIANNINI, B ; CONTE, R</creatorcontrib><description>Antithymocyte globulin (ATG) treatment prevents graft failure and results in a low incidence of GVHD, but an increased risk of relapse could be expected as a consequence of reduced GVHD. From September 1995 to June 2001, 28 consecutive chronic myeloid leukemia (CML) patients underwent unrelated bone marrow transplants: 21 were in chronic phase (CP) and seven in advanced phase (AP). Median age was 35.5 years (range 20-50). HLA typing was based on high-resolution molecular techniques; in eight cases there were one or more allele mismatches. The preparative regimen consisted of TBI, EDX 120 mg/kg and rabbit ATG 15 mg/kg. All patients engrafted and no rejection occurred. Acute GVHD grade III-IV occurred in six patients (21%). Chronic GVHD occurred in 10 (40%) and it was extensive in one. Four out of seven patients transplanted in AP had a hematological relapse. Of 21 in CP, there was one cytogenetic and one molecular relapse: these two patients are now in complete remission with imatinib mesylate. With a median follow-up of 45.7 months, the 5-year survival is 76.2% for those transplanted in CP. These data demonstrate that transplants performed in CP, with low-dose ATG, are associated with a good outcome, low incidence of GVHD and no increase of relapse.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1704138</identifier><identifier>PMID: 12858193</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animal models in research ; Animals ; Antilymphocyte serum ; Antilymphocyte Serum - administration & dosage ; Biological and medical sciences ; Bone marrow ; Bone marrow transplantation ; Bone Marrow Transplantation - methods ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Care and treatment ; Chronic myeloid leukemia ; Cytogenetics ; Female ; Globulins ; Graft rejection ; Graft versus host reaction ; Graft vs Host Disease - drug therapy ; Graft vs Host Disease - prevention & control ; Grafts ; Hematologic and hematopoietic diseases ; Histocompatibility antigen HLA ; Histocompatibility Testing ; Humans ; Imatinib ; Incidence ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Middle Aged ; Myeloid leukemia ; Patients ; Prevention ; Rabbits ; Remission ; Secondary Prevention ; Stem cell transplantation ; Survival Analysis ; Thymocytes ; Tissue typing ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation Conditioning - methods ; Transplants ; Treatment Outcome</subject><ispartof>Bone marrow transplantation (Basingstoke), 2003-08, Vol.32 (3), p.237-242</ispartof><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Aug 1, 2003</rights><rights>Nature Publishing Group 2003.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-a013a269b5e8487b5a38f58e11f0e6fbd466ed58c91c822564fd6af0ecd056923</citedby><cites>FETCH-LOGICAL-c507t-a013a269b5e8487b5a38f58e11f0e6fbd466ed58c91c822564fd6af0ecd056923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14942260$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12858193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BONIFAZI, F</creatorcontrib><creatorcontrib>BANDINI, G</creatorcontrib><creatorcontrib>BACCARANI, M</creatorcontrib><creatorcontrib>RONDELLI, D</creatorcontrib><creatorcontrib>FALCIONI, S</creatorcontrib><creatorcontrib>STANZANI, M</creatorcontrib><creatorcontrib>BONTADINI, A</creatorcontrib><creatorcontrib>TAZZARI, P. L</creatorcontrib><creatorcontrib>ARPINATI, M</creatorcontrib><creatorcontrib>GIANNINI, B</creatorcontrib><creatorcontrib>CONTE, R</creatorcontrib><title>Reduced incidence of GVHD without increase in relapse with low-dose rabbit ATG in the preparative regimen for unrelated bone marrow transplants in CML</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Antithymocyte globulin (ATG) treatment prevents graft failure and results in a low incidence of GVHD, but an increased risk of relapse could be expected as a consequence of reduced GVHD. From September 1995 to June 2001, 28 consecutive chronic myeloid leukemia (CML) patients underwent unrelated bone marrow transplants: 21 were in chronic phase (CP) and seven in advanced phase (AP). Median age was 35.5 years (range 20-50). HLA typing was based on high-resolution molecular techniques; in eight cases there were one or more allele mismatches. The preparative regimen consisted of TBI, EDX 120 mg/kg and rabbit ATG 15 mg/kg. All patients engrafted and no rejection occurred. Acute GVHD grade III-IV occurred in six patients (21%). Chronic GVHD occurred in 10 (40%) and it was extensive in one. Four out of seven patients transplanted in AP had a hematological relapse. Of 21 in CP, there was one cytogenetic and one molecular relapse: these two patients are now in complete remission with imatinib mesylate. With a median follow-up of 45.7 months, the 5-year survival is 76.2% for those transplanted in CP. These data demonstrate that transplants performed in CP, with low-dose ATG, are associated with a good outcome, low incidence of GVHD and no increase of relapse.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animal models in research</subject><subject>Animals</subject><subject>Antilymphocyte serum</subject><subject>Antilymphocyte Serum - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone Marrow Transplantation - methods</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Care and treatment</subject><subject>Chronic myeloid leukemia</subject><subject>Cytogenetics</subject><subject>Female</subject><subject>Globulins</subject><subject>Graft rejection</subject><subject>Graft versus host reaction</subject><subject>Graft vs Host Disease - drug therapy</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>Grafts</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Histocompatibility antigen HLA</subject><subject>Histocompatibility Testing</subject><subject>Humans</subject><subject>Imatinib</subject><subject>Incidence</subject><subject>Leukemia</subject><subject>Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myeloid leukemia</subject><subject>Patients</subject><subject>Prevention</subject><subject>Rabbits</subject><subject>Remission</subject><subject>Secondary Prevention</subject><subject>Stem cell transplantation</subject><subject>Survival Analysis</subject><subject>Thymocytes</subject><subject>Tissue typing</subject><subject>Transfusions. Complications. Transfusion reactions. 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Graft versus host reaction</topic><topic>Care and treatment</topic><topic>Chronic myeloid leukemia</topic><topic>Cytogenetics</topic><topic>Female</topic><topic>Globulins</topic><topic>Graft rejection</topic><topic>Graft versus host reaction</topic><topic>Graft vs Host Disease - drug therapy</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>Grafts</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Histocompatibility antigen HLA</topic><topic>Histocompatibility Testing</topic><topic>Humans</topic><topic>Imatinib</topic><topic>Incidence</topic><topic>Leukemia</topic><topic>Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myeloid leukemia</topic><topic>Patients</topic><topic>Prevention</topic><topic>Rabbits</topic><topic>Remission</topic><topic>Secondary Prevention</topic><topic>Stem cell transplantation</topic><topic>Survival Analysis</topic><topic>Thymocytes</topic><topic>Tissue typing</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Transplantation Conditioning - methods</topic><topic>Transplants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BONIFAZI, F</creatorcontrib><creatorcontrib>BANDINI, G</creatorcontrib><creatorcontrib>BACCARANI, M</creatorcontrib><creatorcontrib>RONDELLI, D</creatorcontrib><creatorcontrib>FALCIONI, S</creatorcontrib><creatorcontrib>STANZANI, M</creatorcontrib><creatorcontrib>BONTADINI, A</creatorcontrib><creatorcontrib>TAZZARI, P. 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L</au><au>ARPINATI, M</au><au>GIANNINI, B</au><au>CONTE, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduced incidence of GVHD without increase in relapse with low-dose rabbit ATG in the preparative regimen for unrelated bone marrow transplants in CML</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2003-08-01</date><risdate>2003</risdate><volume>32</volume><issue>3</issue><spage>237</spage><epage>242</epage><pages>237-242</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Antithymocyte globulin (ATG) treatment prevents graft failure and results in a low incidence of GVHD, but an increased risk of relapse could be expected as a consequence of reduced GVHD. From September 1995 to June 2001, 28 consecutive chronic myeloid leukemia (CML) patients underwent unrelated bone marrow transplants: 21 were in chronic phase (CP) and seven in advanced phase (AP). Median age was 35.5 years (range 20-50). HLA typing was based on high-resolution molecular techniques; in eight cases there were one or more allele mismatches. The preparative regimen consisted of TBI, EDX 120 mg/kg and rabbit ATG 15 mg/kg. All patients engrafted and no rejection occurred. Acute GVHD grade III-IV occurred in six patients (21%). Chronic GVHD occurred in 10 (40%) and it was extensive in one. Four out of seven patients transplanted in AP had a hematological relapse. Of 21 in CP, there was one cytogenetic and one molecular relapse: these two patients are now in complete remission with imatinib mesylate. With a median follow-up of 45.7 months, the 5-year survival is 76.2% for those transplanted in CP. These data demonstrate that transplants performed in CP, with low-dose ATG, are associated with a good outcome, low incidence of GVHD and no increase of relapse.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>12858193</pmid><doi>10.1038/sj.bmt.1704138</doi><tpages>6</tpages></addata></record> |
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| ispartof | Bone marrow transplantation (Basingstoke), 2003-08, Vol.32 (3), p.237-242 |
| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals (MCLS); Nature; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animal models in research Animals Antilymphocyte serum Antilymphocyte Serum - administration & dosage Biological and medical sciences Bone marrow Bone marrow transplantation Bone Marrow Transplantation - methods Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Chronic myeloid leukemia Cytogenetics Female Globulins Graft rejection Graft versus host reaction Graft vs Host Disease - drug therapy Graft vs Host Disease - prevention & control Grafts Hematologic and hematopoietic diseases Histocompatibility antigen HLA Histocompatibility Testing Humans Imatinib Incidence Leukemia Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Middle Aged Myeloid leukemia Patients Prevention Rabbits Remission Secondary Prevention Stem cell transplantation Survival Analysis Thymocytes Tissue typing Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplantation Conditioning - methods Transplants Treatment Outcome |
| title | Reduced incidence of GVHD without increase in relapse with low-dose rabbit ATG in the preparative regimen for unrelated bone marrow transplants in CML |
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