Rabbit anti-thymocyte globulin (ATG) is used as prophylaxis against GVHD following allogeneic hematopoietic cell transplantation (HCT). At our institution, ATG is exclusively used in the conditioning of matched unrelated donor (URD) transplant recipients. A total of 50 URD HCT recipients who received ATG (ATG group) were retrospectively compared with 48 matched related donor (MRD) HCT recipients who did not receive ATG (no ATG group). There were no significant differences between the groups in rates of day 100 mortality, acute GVHD or relapse. Chronic GVHD incidence was significantly lower in the ATG group (P = 0.007). At a median follow-up of 36 months in the entire cohort, 50% patients are alive in the ATG group and 63% of the patients are alive in the no ATG group (P = 0.13). We conclude that the administration of ATG to patients undergoing URD HCT preserves the anti-leukemia benefit of the transplant, while reducing the risk of developing GVHD, resulting in OS rates that are comparable to MRD HCT recipients.
between the groups except a higher percentage of normal cytogenetics in patients with FLT3/ITD+ (p 5 0.025).Two year OS, DFS, non-relapse mortality (NRM), and relapse of cohort were 60.8%, 55.8%, 18.0% and 31.3%, respectively. Univariate analysis showed FLT3/ITD+ compared to FLT3/ITD-patients was significantly associated with inferior DFS (2 year DFS: 19% vs. 64%, p\0.0027), increased risk of relapse (1 year: 59% vs. 19%, p\0.0009), and a trend towards decreased OS (p 5 0.08). 5 of the 16 FLT3/ITD+ patients were also positive for NPM1, which did not impact outcome. Multivariate analysis using the Cox proportion hazard regression model confirmed that FLT3/ITD+ mutations independently predicted a shorter DFS (hazard ratio [HR], 3.0; 95% CI, 1.4-6.5; p 5 0.004) and increased risk of relapse (HR, 4.9; 95% CI, 2.0-12.3, p 5 0.001). Time to relapse in patients with FLT3/ITD+ was very short with 100 days cumulative risk of 45%. Conclusion: Our data suggests that allo-SCT in FLT3/ITD+ AML CR1 does not appear to overcome the poor prognostic value, and these patients remain at high risk of early relapse even after allo-SCT. While our study is limited by small size, this further illustrates the urgent need for larger prospective studies to validate the efficacy of allo-SCT in CR1 and the need to design therapy targeting FLT3/ ITD either prior to or early-post transplant to decrease relapse for this specific subgroup.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.