title: Impact of rabbit ATG-containing myeloablative conditioning regimens on the outcome of patients undergoing unrelated single-unit cord blood transplantation for hematological malignancies.
abstract: This study aimed to assess the impact of antithymocyte globulin (ATG) on patient outcome in a retrospective series of 91 patients (median age: 12 years) who underwent unrelated single-unit cord blood transplantation (allo-CBT) following a myeloablative conditioning regimen. Cord blood units were HLA-matched (6/6, n=18; 21%), one-Ag mismatched (n=30, 35%) or two-Ag mismatched (n=38; 44%). In this series, the OS, nonrelapse mortality (NRM) and cumulative incidence of relapse were 47±6%, 23±4% and 48±5%, respectively. Among 46 patients who received ATG as part of the conditioning regimen, the incidence of acute and chronic GVHD was lower than that in the group of 45 patients who did not receive ATG (20% vs 43%; P=0.03). However, multivariate statistical analysis revealed that the ATG use was associated with decreased OS and EFS rates and a high incidence of NRM (hazard ratio (HR)=1.99, 95% confidence interval (CI): 1.11-3.59, P=0.02), (HR=1.83, 95% CI: 1.08-3.10, P=0.02) and (HR=2.54, 95% CI: 1.03-6.26, P=0.04), respectively. Therefore, our results do not support the use of ATG as part of a myeloablative-conditioning regimen before single-unit allo-CBT in younger patients with hematological malignancies.
authors.affiliation: 1] Onco-hématologie, Université Catholique de Lille, Lille, France [2] EA2686, Laboratoire d'Immunologie HLA, CHRU de Lille, Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Pascal
authors.affiliation: 1] Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, Paris, France [2] Université Pierre et Marie Curie, Paris, France [3] INSERM, UMRs 938, Paris, France [4] Centre Hospitalier et Universitaire de Nantes, Hématologie Clinique, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Eurocord, Hôpital Saint Louis APHP, Université Paris-Diderot, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Ruggeri
authors.affiliation: Eurocord, Hôpital Saint Louis APHP, Université Paris-Diderot, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Tucunduva
authors.affiliation: Hôpital Haut-Lévèque, Avenue de Magellan, Pessac, France.
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.affiliation: Centre Hospitalier et Universitaire de Nantes, Hématologie Clinique, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: Hôpital Haut-Lévèque, Avenue de Magellan, Pessac, France.
authors.forename: R
authors.initials: R
authors.lastname: Tabrizi
authors.affiliation: EA2686, Laboratoire d'Immunologie HLA, CHRU de Lille, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Labalette
authors.affiliation: Eurocord, Hôpital Saint Louis APHP, Université Paris-Diderot, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.affiliation: Centre International greffes and Acute Leukemia Working Party (ALWP), EBMT Paris Office, Hôpital Saint Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: 1] EA2686, Laboratoire d'Immunologie HLA, CHRU de Lille, Lille, France [2] UAM Allogreffe de CSH, Centre Hospitalier et Universitaire de Lille, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D064591:Allografts; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D015996:Survival Rate; D019172:Transplantation Conditioning
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents