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Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: a 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire.

Mauricette Michallet 1 Quoc-Hung Le 1 Mohamad Mohty 2, 3 Thomas Prébet 1 Franck Nicolini 1 Jean Michel Boiron 1 Hélène Esperou 4 Michel Attal 5 Noel Milpied 6 Bruno Lioure 7 Pierre Bordigoni 8 Ibrahim Yakoub-Agha 8 Jean-Henri Bourhis 7 Bernard Rio 9 Eric Deconinck 10, 11 Marc Renaud 9 Zina Chir 9 Didier Blaise 12
1 Service d'hématologie [Hôpital Edouard Herriot - HCL]
2 Service d'hématologie clinique
3 CRCNA - Centre de Recherche en Cancérologie Nantes-Angers
4 Agence de la biomédecine [Saint-Denis la Plaine]
5 Laboratoire d'Hématologie [Purpan]
6 Service des maladies du sang
7 Service d'onco-hématologie
8 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
9 Département d'Hématologie et Oncologie Médicale
10 Service greffe de moelle osseuse
11 RIGHT - Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098)
12 Hôpital Haut-Lévêque
Abstract : This retrospective study analyzed the impact of demographic and transplantation variables on outcomes of 1108 patients who have undergone allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning (RIC HSCT) for hematological malignancies and were reported to the Société Française de Greffe de Moelle et de Thérapie Cellulaire registry between November 1994 and December 2004. Only 442 patients (40%) were in complete remission (CR) at time of transplantation. Peripheral blood stem cells were used in the majority of patients (n = 878; 79%), 255 patients received fludarabine and low-dose total body irradiation, while 465 patients (42%) fludarabine and busulfan with rabbit anti-thymocyte globulins (ATG). The impact of demographic and transplant variables was studied on overall (OS) and event-free survival (EFS) in univariate and multivariate analysis. With a median follow-up of 21 months, 3-year probability of OS and EFS was 42% and 30%, respectively, and treatment-related mortality was 15% at 2 years. The multivariate analysis showed a significant negative impact on OS and EFS of the absence of CR status before transplantation; conditioning regimen, including >10 mg/kg ATG; and minor ABO incompatibility. In conclusion, this study highlights the major impact on RIC HSCT outcome of disease status before transplantation, ATG dose and ABO incompatibility.
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https://www.hal.inserm.fr/inserm-00484237
Contributor : Philippe Saas <>
Submitted on : Tuesday, May 18, 2010 - 10:59:32 AM
Last modification on : Tuesday, October 27, 2020 - 2:35:50 PM

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UNIV-FCOMTE | UMR645 | HCL | HEH | UNIV-PARIS7 | CNRS | USPC | UNAM | UNIV-TLSE3 | UNIV-PARIS

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Mauricette Michallet, Quoc-Hung Le, Mohamad Mohty, Thomas Prébet, Franck Nicolini, et al.. Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: a 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire.. Experimental Hematology, Elsevier, 2008, 36 (5), pp.535-44. ⟨10.1016/j.exphem.2008.01.017⟩. ⟨inserm-00484237⟩

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