Marsh, J C and Pearce, R M and Koh, M B C and Lim, Z and Pagliuca, A and Mufti, G J and Perry, J and Snowden, J A and Vora, A J and Wynn, R T and Russell, N and Gibson, B and Gilleece, M and Milligan, Donald and Veys, P and Samarasinghe, S and McMullin, M and Kirkland, K and Cook, G (2014) Retrospective study of alemtuzumab vs ATG-based conditioning without irradiation for unrelated and matched sibling donor transplants in acquired severe aplastic anemia: a study from the British Society for Blood and Marrow Transplantation. Bone marrow transplantation, 49 (1). pp. 42-8. ISSN 1476-5365. Full Text available via official URL.Full text not available from this repository.
This retrospective national study compared the use of alemtuzumab-based conditioning regimens for hematopoietic SCT (HSCT) in acquired severe aplastic anemia with antithymocyte globulin (ATG)-based regimens. One hundred patients received alemtuzumab and 55 ATG-based regimens. A matched sibling donor (MSD) was used in 87 (56%), matched unrelated donor (MUD) in 60 (39%) and other related or mismatched unrelated donor (UD) in 8 (5%) patients. Engraftment failure occurred in 9% of the alemtuzumab group and 11% of the ATG group. Five-year OS was 90% for the alemtuzumab and 79% for the ATG groups, P=0.11. For UD HSCT, OS of patients was better when using alemtuzumab (88%) compared with ATG (57%), P=0.026, although smaller numbers of patients received ATG. Similar outcomes for MSD HSCT using alemtuzumab or ATG were seen (91% vs 85%, respectively, P=0.562). A lower risk of chronic GVHD (cGVHD) was observed in the alemtuzumab group (11% vs 26%, P=0.031). On multivariate analysis, use of BM as stem cell source was associated with better OS and EFS, and less acute and cGVHD; young age was associated with better EFS and lower risk of graft failure. This large study confirms successful avoidance of irradiation in the conditioning regimens for MUD HSCT patients.
|Additional Information:||Full Text available via official URL.|
WH Haemic and lymphatic systems. Haematology
|Divisions:||Planned IP Care > Oncology and Clinical Haematology|
|Depositing User:||Sophie Rollason|
|Date Deposited:||04 Jul 2014 09:34|
|Last Modified:||04 Jul 2014 09:34|
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