Outcomes following HSCT using fludarabine, busulfan, and thymoglobulin: a matched comparison to allogeneic transplants conditioned with busulfan and cyclophosphamide.
Outcomes following HSCT using fludarabine, busulfan, and thymoglobulin: a matched comparison to allogeneic transplants conditioned with busulfan and cyclophosphamide.
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DOI：
10.1016/j.bbmt.2008.06.009
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发表时间：
2008-09
期刊：
影响因子：
--
通讯作者：
Stewart DA
中科院分区：
文献类型：
--
作者：
Bredeson CN;Zhang MJ;Agovi MA;Bacigalupo A;Bahlis NJ;Ballen K;Brown C;Chaudhry MA;Horowitz MM;Kurian S;Quinlan D;Muehlenbien CE;Russell JA;Savoie L;Rizzo JD;Stewart DA
我们已经报道了一种新的预处理方案，使用低剂量兔抗胸腺细胞球蛋白（TG，Thymoglobulin）与氟达拉滨和静脉内白消安（FluBuTG）的急性移植物抗宿主病（aGVHD）的发病率较低。为了进一步评估这一单中心经验，我们进行了一项回顾性配对分析，比较了使用FluBuTG预处理方案移植的成人患者与来自CIBMTR报告的在标准口服白消安和环磷酰胺（BuCy）后接受首次异基因造血干细胞移植（HCT）的患者的匹配对照的结局。120例病例和215例匹配对照可用于比较。与BuCy患者相比，接受FluBuTG的患者治疗相关死亡率（12% vs 34%，p<0.001）和II-IV级aGVHD（15% vs 34%，p<0.001）显著降低。FluBuTG患者的复发风险较高（42% vs 20%，p<0.001）。慢性GVHD（cGVHD）和无病生存期（DFS）的风险在病例组和对照组中相似。这些结果表明，新的方案FluBuTG降低了HLA相同的同胞HCT后aGVHD和移植死亡率的风险，但与复发风险增加相关，导致相似的DFS。这些预处理方案是否更适合基于复发风险的特定患者人群，需要在前瞻性随机试验中进行测试。
We have reported a lower incidence of acute graft versus host disease (aGVHD) with a novel conditioning regimen using low dose rabbit anti-thymocyte globulin (TG, Thymoglobulin) with fludarabine and intravenous busulfan (FluBuTG). To assess further this single center experience, we performed a retrospective matched pair analysis comparing outcomes of adult patients transplanted using the FluBuTG conditioning regimen with matched controls from patients reported to the CIBMTR receiving a first allogeneic hematopoietic stem cell transplant (HCT) after standard oral busulfan and cyclophosphamide (BuCy). 120 cases and 215 matched controls were available for comparison. Patients receiving FluBuTG had significantly less treatment related mortality (12% vs 34%, p<0.001) and grades II–IV aGVHD (15% vs 34% p<0.001) compared to BuCy patients. The risk of relapse was higher in the FluBuTG patients (42% vs 20%, p<0.001). The risks of chronic GVHD (cGVHD) and disease free survival (DFS) were similar in the cases and controls. These results suggest that the novel regimen FluBuTG decreases the risk of aGVHD and transplant mortality after HLA-identical sibling HCT, but is associated with an increased risk of relapse, resulting in similar DFS. Whether these conditioning regimens may be more suitable for specific patient populations based on relapse risk requires testing in prospective randomized trials.
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DOI：
10.1053/bbmt.2002.v8.pm12374451
发表时间：
2002-01-01
影响因子：
4.3
作者：
Russell, JA;Tran, HT;Andersson, BS
通讯作者：
Andersson, BS
影响因子：
4.8
作者：
Remberger, M;Storer, B;Anasetti, C
通讯作者：
Anasetti, C
影响因子：
4.8
作者：
Kröger, N;Zabelina, T;Zander, AR
通讯作者：
Zander, AR
影响因子：
4.3
作者：
Sandmaier, Brenda M.;Mackinnon, Stephen;Childs, Richard W.
通讯作者：
Childs, Richard W.
影响因子：
20.3
作者：
Slavin, S;Nagler, A;Or, R
通讯作者：
Or, R