Prognostic impact of immune status and hematopoietic recovery before and after fludarabine, IV busulfan, and antithymocyte globulins (FB2 regimen) reduced-intensity conditioning regimen (RIC) allogeneic stem cell transplantation (allo-SCT).
Eur J Haematol
; 90(3): 177-86, 2013 Mar.
Article
em En
| MEDLINE
| ID: mdl-23301689
ABSTRACT
This retrospective analysis aimed to assess hematopoietic and immune recovery in a cohort of 53 patients [males n = 33; median age 59 yr (range 22-70)] who received a FB2 (fludarabine 120-150 mg/m² + IV busulfan 6.4 mg/kg + antithymocyte globulin thymoglobulin 5 mg/kg) reduced-intensity conditioning (RIC) allo-stem cells transplantations (SCT). With a median follow-up of 19 months (range 2-53), the 2-yr overall survival, disease-free survival (DFS), relapse incidence, and non-relapse mortality were 63%, 59.5%, 35%, and 6%, respectively. In univariate analysis, the factors correlated with a significantly higher 2-yr OS and DFS were a higher total circulating lymphocytes count at transplant (>730/mm(3) ; OS 81% vs. 43%, P = 0.02; DFS 73% vs. 45.5%, P = 0.03) and a higher recovery of leukocytes (>5300/mm(3) ) (2-yr OS 81% vs. 44%, P = 0.007; 2-yr DFS 72% vs. 46%, P = 0.08), neutrophils (>3200/mm(3) ) (2-yr OS 76% vs. 50%, P = 0.03; 2-yr DFS 67% vs. 52.0%, P = 0.1), and monocytes (>590/mm(3) ; 2-yr OS 80% vs. 45%, P = 0.004; 2-yr DFS 76% vs. 42%, P = 0.01) at day +30 post-transplant. In multivariate analysis, the only independent factors associated with a significantly higher OS and DFS were a better immune status at transplant (lymphocytes count >730/mm(3) ) and a higher monocytes count (>590/mm(3) ) at day +30 post-transplant. These results suggest that immune status and hematopoietic recovery before and after FB2 RIC allo-SCT can be significant predictors of outcome. This paves the way for future studies aiming to closely monitor the kinetics of immune recovery after RIC allo-SCT and to evaluate the impact of growth factors and other immunostimulatory cytokines in the setting of RIC allo-SCT.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
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Tipos_de_cancer
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Leucemia
Base de dados:
MEDLINE
Assunto principal:
Vidarabina
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Bussulfano
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Leucemia
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Transplante de Células-Tronco Hematopoéticas
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Condicionamento Pré-Transplante
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Agonistas Mieloablativos
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Linfoma
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Mieloma Múltiplo
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Soro Antilinfocitário
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Haematol
Assunto da revista:
HEMATOLOGIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
França