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Alemtuzumab vs anti‐thymocyte globulin in patients transplanted from an unrelated donor after a reduced intensity conditioning
Author(s) -
Robin Marie,
Raj Kavita,
Chevret Sylvie,
Gauthier Jordan,
Lavallade Hugues,
Michonneau David,
McLornan Donal,
Peffault de Latour Régis,
Potter Victoria,
Kulasekararaj Austin,
Sicre de Fontbrune Flore,
Pagliuca Antonio,
YakoubAgha Ibrahim,
Socié Gérard,
Mufti Ghulam J.
Publication year - 2018
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13085
Subject(s) - alemtuzumab , anti thymocyte globulin , medicine , hematopoietic stem cell transplantation , transplantation , regimen , graft versus host disease , immunology , gastroenterology , myeloid , oncology
Objective Relapse and graft‐vs‐host disease (GVHD) are still the main complications after allogeneic hematopoietic stem cell transplantation, especially in the setting of reduced intensity regimen ( RIC ) and unrelated donor. We compared here anti‐thymocyte globulin ( ATG ) or alemtuzumab as GVHD prophylaxis in patients with myeloid disease transplanted after RIC and from an unrelated donor. Method ATG and alemtuzumab patients have been matched by age, gender, HLA matching, comorbidities and cytogenetics risk (119 patients in each group). Results After matching, we found that ATG decreased the risk of relapse ( HR : 0.55, P = .0049) and improved relapse‐free survival ( RFS , HR : 0.70, P = .042). The improved RFS with ATG was more pronounced in CMV ‐positive patients but was not influenced by disease risk. Regarding overall survival, GVHD ‐free relapse‐free survival and transplant‐related mortality, the risk was similar using ATG or alemtuzumab. Conclusion Even if GVHD risk is lowered by alemtuzumab use, it does not translate in better outcome due to higher risk of relapse.