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Article: Impact of immune modulation with in vivo T-cell depletion and myleoablative total body irradiation conditioning on outcomes after unrelated donor transplantation for childhood acute lymphoblastic leukemia

TitleImpact of immune modulation with in vivo T-cell depletion and myleoablative total body irradiation conditioning on outcomes after unrelated donor transplantation for childhood acute lymphoblastic leukemia
Authors
Issue Date2012
Citation
Blood, 2012, v. 119, n. 25, p. 6155-6161 How to Cite?
AbstractTo determine whether in vivo T-cell depletion, which lowers GVHD, abrogates the antileukemic benefits of myeloablative total body irradiation-based conditioning and unrelated donor transplantation, in the present study, we analyzed 715 children with acute lymphoblastic leukemia. Patients were grouped for analysis according to whether conditioning included antithymocyte globulin (ATG; n = 191) or alemtuzumab (n = 132) and no in vivo T-cell depletion (n = 392). The median follow-up time was 3.5 years for the ATG group and 5 years for the alemtuzumab and T cell-replete groups. Using Cox regression analysis, we compared transplantation outcomes between groups. Compared with no T-cell depletion, grade 2-4 acute and chronic GVHD rates were significantly lower after in vivo T-cell depletion with ATG (relative risk [RR] = 0.66; P = .005 and RR = 0.55; P < .0001, respectively) or alemtuzumab (RR = 0.09; P < .003 and RR = 0.21; P < .0001, respectively). Despite lower GVHD rates after in vivo T-cell depletion, nonrelapse mortality, relapse, overall survival, and leukemia-free survival (LFS) did not differ significantly among the treatment groups. The 3-year probabilities of LFS after ATG-containing, alemtuzumab-containing, and T cell-replete transplantations were 43%, 49%, and 46%, respectively. These data suggest that in vivo T-cell depletion lowers GVHD without compromising LFS among children with acute lymphoblastic leukemia who are undergoing unrelated donor transplantation with myeloablative total body irradiation-based regimens. © 2012 by The American Society of Hematology.
Persistent Identifierhttp://hdl.handle.net/10722/294451
ISSN
2023 Impact Factor: 21.0
2023 SCImago Journal Rankings: 5.272
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorVeys, Paul-
dc.contributor.authorWynn, Robert F.-
dc.contributor.authorAhn, Kwang Woo-
dc.contributor.authorSamarasinghe, Sujith-
dc.contributor.authorHe, Wensheng-
dc.contributor.authorBonney, Denise-
dc.contributor.authorCraddock, John-
dc.contributor.authorCornish, Jacqueline-
dc.contributor.authorDavies, Stella M.-
dc.contributor.authorDvorak, Christopher C.-
dc.contributor.authorDuerst, Reggie E.-
dc.contributor.authorGross, Thomas G.-
dc.contributor.authorKapoor, Neena-
dc.contributor.authorKitko, Carrie-
dc.contributor.authorKrance, Robert A.-
dc.contributor.authorLeung, Wing-
dc.contributor.authorLewis, Victor A.-
dc.contributor.authorSteward, Colin-
dc.contributor.authorWagner, John E.-
dc.contributor.authorCarpenter, Paul A.-
dc.contributor.authorEapen, Mary-
dc.date.accessioned2020-12-03T08:22:46Z-
dc.date.available2020-12-03T08:22:46Z-
dc.date.issued2012-
dc.identifier.citationBlood, 2012, v. 119, n. 25, p. 6155-6161-
dc.identifier.issn0006-4971-
dc.identifier.urihttp://hdl.handle.net/10722/294451-
dc.description.abstractTo determine whether in vivo T-cell depletion, which lowers GVHD, abrogates the antileukemic benefits of myeloablative total body irradiation-based conditioning and unrelated donor transplantation, in the present study, we analyzed 715 children with acute lymphoblastic leukemia. Patients were grouped for analysis according to whether conditioning included antithymocyte globulin (ATG; n = 191) or alemtuzumab (n = 132) and no in vivo T-cell depletion (n = 392). The median follow-up time was 3.5 years for the ATG group and 5 years for the alemtuzumab and T cell-replete groups. Using Cox regression analysis, we compared transplantation outcomes between groups. Compared with no T-cell depletion, grade 2-4 acute and chronic GVHD rates were significantly lower after in vivo T-cell depletion with ATG (relative risk [RR] = 0.66; P = .005 and RR = 0.55; P < .0001, respectively) or alemtuzumab (RR = 0.09; P < .003 and RR = 0.21; P < .0001, respectively). Despite lower GVHD rates after in vivo T-cell depletion, nonrelapse mortality, relapse, overall survival, and leukemia-free survival (LFS) did not differ significantly among the treatment groups. The 3-year probabilities of LFS after ATG-containing, alemtuzumab-containing, and T cell-replete transplantations were 43%, 49%, and 46%, respectively. These data suggest that in vivo T-cell depletion lowers GVHD without compromising LFS among children with acute lymphoblastic leukemia who are undergoing unrelated donor transplantation with myeloablative total body irradiation-based regimens. © 2012 by The American Society of Hematology.-
dc.languageeng-
dc.relation.ispartofBlood-
dc.titleImpact of immune modulation with in vivo T-cell depletion and myleoablative total body irradiation conditioning on outcomes after unrelated donor transplantation for childhood acute lymphoblastic leukemia-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1182/blood-2012-01-405795-
dc.identifier.pmid22573402-
dc.identifier.pmcidPMC3383023-
dc.identifier.scopuseid_2-s2.0-84862745582-
dc.identifier.volume119-
dc.identifier.issue25-
dc.identifier.spage6155-
dc.identifier.epage6161-
dc.identifier.eissn1528-0020-
dc.identifier.isiWOS:000307398700031-
dc.identifier.f1000717950552-
dc.identifier.issnl0006-4971-

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