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- Title
Growth factor-associated graft-versus-host disease and mortality 10 years after allogeneic bone marrow transplantation.
- Authors
Ringdén, Olle; Labopin, Myriam; Gorin, Norbert-Claude; Volin, Liisa; Torelli, Giovanni F.; Attal, Michel; Jouet, Jean P.; Milpied, Noel; Socié, Gerard; Cordonnier, Catherine; Michallet, Mauricette; Atienza, Arturo I.; Hermine, Olivier; Mohty, Mohamad
- Abstract
Summary This study analysed the effects of growth factor on outcome after haematopoietic stem-cell transplantation ( HSCT) with >9 years follow-up. Of 1887 adult patients with acute leukaemia who received bone marrow from human leucocyte antigen ( HLA)-identical siblings and were treated with myeloablative conditioning, 459 (24%) were treated with growth factor. Growth factor hastened engraftment of neutrophils ( P < 0·0001), but reduced platelet counts ( P = 0·0002). Graft-versus-host disease ( GVHD)-free survival (no acute GVHD grade II-IV or chronic GVHD) at 10 years was 12 ± 2% (± SE) in the growth factor group, as opposed to 17 ± 2% in the controls [hazard ratio ( HR) 0·81, P = 0·001]. Similar differences in GVHD-free survival were seen in patients with or without conditioning with total body irradiation ( TBI). Non-relapse mortality ( NRM) was higher in the growth factor group irrespective of whether or not TBI conditioning was included [ HR = 1·48; 95% confidence interval (CI): 1·15-1·9; P = 0·002; HR = 1·59; 95% CI: 1·07-2·37; P = 0·02, respectively]. Both groups had similar probabilities of leukaemic relapse ( HR = 0·96; 95% CI: 0·78-1·18; P = 0·71). Leukaemia-free survival ( LFS) at 10 years was 35 ± 2% in those receiving growth factor prophylaxis, as opposed to 44 ± 1% in the controls ( HR = 0·70; 95% CI: 0·60-0·82; P = 0·00001). Prophylaxis with growth factor increases the risk of GVHD, does not affect relapse, increases NRM and reduces LFS > 10 years after HSCT, regardless of conditioning with TBI.
- Subjects
GRAFT versus host disease; STEM cell transplantation; GROWTH factors; BONE marrow transplantation; ACUTE leukemia; THERAPEUTICS
- Publication
British Journal of Haematology, 2012, Vol 157, Issue 2, p220
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/j.1365-2141.2012.09034.x