title: Stable long-term pulmonary function after fludarabine, antithymocyte globulin and i.v. BU for reduced-intensity conditioning allogeneic SCT.
abstract: Lung function decline is a well-recognized complication following allogeneic SCT (allo-SCT). Reduced-intensity conditioning (RIC) and in vivo T-cell depletion by administration of antithymocyte globulin (ATG) may have a protective role in the occurrence of late pulmonary complications. This retrospective study reported the evolution of lung function parameters within the first 2 years after allo-SCT in a population receiving the same RIC regimen that included fludarabine and i.v. BU in combination with low-dose ATG. The median follow-up was 35.2 months. With a median age of 59 years at the time of transplant, at 2 years, the cumulative incidences of non-relapse mortality was as low as 9.7%. The cumulative incidence of relapse was 33%. At 2 years, the cumulative incidences of extensive chronic GVHD (cGVHD) and of pulmonary cGVHD were 23.1% and 1.9%, respectively. The cumulative incidences of airflow obstruction and restrictive pattern were 3.8% and 9.6%, respectively. Moreover, forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio remained stable from baseline up to 2 years post transplantation (P=0.26, P=0.27 and P=0.07, respectively). These results correspond favorably with the results obtained with other RIC regimens not incorporating ATG, and suggest that ATG may have a protective pulmonary role after allo-SCT.
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France [2] Faculté de Médecine, Université de Nantes, Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Dirou
authors.affiliation: 1] Faculté de Médecine, Université de Nantes, Nantes, France [2] CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France [3] CRNCA, UMR 892 INSERM - 6299 CNRS, Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Malard
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France [2] Faculté de Médecine, Université de Nantes, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Chambellan
authors.affiliation: CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Germaud
authors.affiliation: CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France.
authors.forename: T
authors.initials: T
authors.lastname: Guillaume
authors.affiliation: CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Delaunay
authors.affiliation: 1] Faculté de Médecine, Université de Nantes, Nantes, France [2] CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France [3] CRNCA, UMR 892 INSERM - 6299 CNRS, Nantes, France [4] Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Moreau
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France [2] Faculté de Médecine, Université de Nantes, Nantes, France [3] INSERM, UMR1087, l'institut du thorax, Nantes, France [4] CNRS, UMR 6291, Nantes, France.
authors.forename: B
authors.initials: B
authors.lastname: Delasalle
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France [2] Faculté de Médecine, Université de Nantes, Nantes, France [3] INSERM, UMR1087, l'institut du thorax, Nantes, France [4] CNRS, UMR 6291, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Lemarchand
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, l'institut du thorax, Service de Pneumologie, Nantes, France [2] Faculté de Médecine, Université de Nantes, Nantes, France [3] CHU de Nantes, Service d'Hématologie Clinique, Université de Nantes, Nantes, France [4] CRNCA, UMR 892 INSERM - 6299 CNRS, Nantes, France [5] Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D002066:Busulfan / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine