Publication Date:
2013-11-15
Description:
To assess the impact of antithymocyte globulins (ATG), on patients' outcome after unrelated cord blood transplantation (UCBT) following a reduced-intensity regimen (RIC), we conducted a retrospective registry-based analysis on 661 adults with hematological malignancies who underwent unrelated single (s) or double (d) UCBT following RIC with the TBI/cyclophosphamide/fludarabine regimen (TCF) between 2004 and 2011 in EBMT centers. Participating centers were asked to provide additional information on type, timing and total dose of ATG used. Diagnosis was AML/ALL in 51%, MDS/CML in 19% and lymphoid malignancies in 30%; 28% of patients were transplanted in early disease status, 28% in intermediate and 44% in advanced disease. Thirty percent of patients had a previous autologous transplantation. Single UCBT was used in 226 (34%) patients, while 435 (66%) were transplanted with dUCBT. HLA matching was defined as low resolution for HLA-A and HLA-B, and high resolution for HLA-DRB1, and for dUCBT, the highest degree of HLA incompatibility was considered. Therefore, most of the HLA incompatibilities were 4/6 (n=435, 72%). Median number of collected total nucleated and CD34+ cells were 4.4x107/kg and 1.6x105/kg, respectively. All patients received TCF, with TBI 2Gy (86%), TBI 4Gy (12%) and TBI 6Gy (2%). Rabitt ATG (rATG) was used as part of RIC in 82 patients (12.4%) with a median total dose of rATG (Fresenius®) of 20mg/kg (5-60) and rATG (Genzyme®) of 8mg/kg (5-15). GVHD prophylaxis consisted of cyclosporine A (CsA)+ mycophenolate mofetil (MMF) in 91%, Csa alone±other in 9%. The median follow-up was 36.3 months. When compared to patients not receiving rATG-TCF, patients given rATG-TCF had more MDS/CML (30% vs 20%, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine