دورية أكاديمية
Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia : a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation
| العنوان: | Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia : a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation |
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| المؤلفون: | Baron, Frédéric, Labopin, M., Niederwieser, D., Vigouroux, S., Cornelissen, JJ., Malm, C., Vindelov, LL., Blaise, D., Janssen, JJWM, Petersen, E., Socié, G., Nagler, A., Rocha, V., Mohty, M. |
| المصدر: | Leukemia, 26 (12), 2462-2468 (2012-12) |
| بيانات النشر: | Nature Publishing Group, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | reduced-intensity conditioning, AML, GVHD, chronic, graft-versus-leukemia effects, Human health sciences, Hematology, Sciences de la santé humaine, Hématologie |
| الوصف: | This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk of relapse (hazards ratio (HR)¼0.7, P¼0.02) translating into a trend for better overall survival (OS; HR¼1.3; P¼0.07). Grade II acute GVHD had no net impact on OS, while grade III–IV acute GVHD was associated with a worse OS (HR¼0.4, Po0.0.001) owing to high risk of nonrelapse mortality (NRM; HR¼5.2, Po0.0001). In time-dependent multivariate Cox analyses, limited chronic GVHD tended to be associated with a lower risk of relapse (HR¼0.72; P¼0.07) translating into a better OS (HR¼1.8; Po0.001), while extensive chronic GVHD was associated with a lower risk of relapse (HR¼0.65; P¼0.02) but also with higher NRM (HR¼3.5; Po0.001) and thus had no net impact on OS. In-vivo T-cell depletion with antithymocyte globulin (ATG) or alemtuzumab was successful at preventing extensive chronic GVHD (Po0.001), but without improving OS for ATG and even with worsening OS for alemtuzumab (HR¼0.65; P¼0.001). These results highlight the role of the immune-mediated graft-versus-leukemia effect in the RIC allo-SCT setting, but also the need for improving the prevention and treatment of severe GVHD. |
| نوع الوثيقة: | journal article http://purl.org/coar/resource_type/c_6501 article |
| اللغة: | English |
| Relation: | urn:issn:0887-6924; urn:issn:1476-5551 |
| DOI: | 10.1038/leu.2012.135 |
| URL الوصول: | https://orbi.uliege.be/handle/2268/134741 |
| حقوق: | open access http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess |
| رقم الأكسشن: | edsorb.134741 |
| قاعدة البيانات: | ORBi |
| DOI: | 10.1038/leu.2012.135 |
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