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Statements

Subject Item
n2:RIV%2F00669806%3A_____%2F11%3A10209994%21RIV14-MZ0-00669806
rdf:type
n5:Vysledek skos:Concept
rdfs:seeAlso
http://bloodjournal.hematologylibrary.org/content/117/23/6375.long
dcterms:description
Previous randomized graft-versus-host disease (GVHD)-prophylaxis trials have failed to demonstrate reduced incidence and severity of chronic GVHD (cGVHD). Here we reanalyzed and updated a randomized phase 3 trial comparing standard GVHD prophylaxis with or without pretransplantation ATG-Fresenius (ATG-F) in 201 adult patients receiving myeloablative conditioning before transplantation from unrelated donors. The cumulative incidence of extensive cGVHD after 3 years was 12.2% in the ATG-F group versus 45.0% in the control group (P < .0001). The 3-year cumulative incidence of relapse and of nonrelapse mortality was 32.6% and 19.4% in the ATG-F group and 28.2% and 33.5% in the control group (hazard ratio [HR] = 1.21, P =.47, and HR = 0.68, P =.18), respectively. This nonsignificant reduction in nonrelapse mortality without increased relapse risk led to an overall survival rate after 3 years of 55.2% in the ATG-F group and 43.3% in the control group (HR = 0.84, P =.39, nonsignificant). The HR for receiving immunosuppressive therapy (IST) was 0.31 after ATG-F (P <.0001), and the 3-year probability of survival free of IST was 52.9% and 16.9% in the ATG-F versus control, respectively. The addition of ATG-F to standard cyclosporine, methotrexate GVHD prophylaxis lowers the incidence and severity of cGVHD, and the risk of receiving IST without raising the relapse rate. ATG-F prophylaxis reduces cGVHD morbidity. Previous randomized graft-versus-host disease (GVHD)-prophylaxis trials have failed to demonstrate reduced incidence and severity of chronic GVHD (cGVHD). Here we reanalyzed and updated a randomized phase 3 trial comparing standard GVHD prophylaxis with or without pretransplantation ATG-Fresenius (ATG-F) in 201 adult patients receiving myeloablative conditioning before transplantation from unrelated donors. The cumulative incidence of extensive cGVHD after 3 years was 12.2% in the ATG-F group versus 45.0% in the control group (P < .0001). The 3-year cumulative incidence of relapse and of nonrelapse mortality was 32.6% and 19.4% in the ATG-F group and 28.2% and 33.5% in the control group (hazard ratio [HR] = 1.21, P =.47, and HR = 0.68, P =.18), respectively. This nonsignificant reduction in nonrelapse mortality without increased relapse risk led to an overall survival rate after 3 years of 55.2% in the ATG-F group and 43.3% in the control group (HR = 0.84, P =.39, nonsignificant). The HR for receiving immunosuppressive therapy (IST) was 0.31 after ATG-F (P <.0001), and the 3-year probability of survival free of IST was 52.9% and 16.9% in the ATG-F versus control, respectively. The addition of ATG-F to standard cyclosporine, methotrexate GVHD prophylaxis lowers the incidence and severity of cGVHD, and the risk of receiving IST without raising the relapse rate. ATG-F prophylaxis reduces cGVHD morbidity.
dcterms:title
Chronic graft-versus-host disease: long-term results from a randomized trial on graft-versus-host disease prophylaxis with or without anti-T-cell globulin ATG-Fresenius Chronic graft-versus-host disease: long-term results from a randomized trial on graft-versus-host disease prophylaxis with or without anti-T-cell globulin ATG-Fresenius
skos:prefLabel
Chronic graft-versus-host disease: long-term results from a randomized trial on graft-versus-host disease prophylaxis with or without anti-T-cell globulin ATG-Fresenius Chronic graft-versus-host disease: long-term results from a randomized trial on graft-versus-host disease prophylaxis with or without anti-T-cell globulin ATG-Fresenius
skos:notation
RIV/00669806:_____/11:10209994!RIV14-MZ0-00669806
n5:predkladatel
n6:ico%3A00669806
n3:aktivita
n19:V n19:I
n3:aktivity
I, V
n3:cisloPeriodika
23
n3:dodaniDat
n14:2014
n3:domaciTvurceVysledku
n4:6662986
n3:druhVysledku
n7:J
n3:duvernostUdaju
n17:S
n3:entitaPredkladatele
n16:predkladatel
n3:idSjednocenehoVysledku
190343
n3:idVysledku
RIV/00669806:_____/11:10209994
n3:jazykVysledku
n10:eng
n3:klicovaSlova
survival; depletion; competing risks; clinical-trials; antithymocyte globulin; follow-up; working group-report; matched unrelated donors; consensus development project; Bone-marrow-transplantation
n3:klicoveSlovo
n9:clinical-trials n9:survival n9:consensus%20development%20project n9:matched%20unrelated%20donors n9:antithymocyte%20globulin n9:follow-up n9:depletion n9:competing%20risks n9:working%20group-report n9:Bone-marrow-transplantation
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[0746C4CFC5D9]
n3:nazevZdroje
Blood
n3:obor
n18:FD
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
23
n3:rokUplatneniVysledku
n14:2011
n3:svazekPeriodika
117
n3:tvurceVysledku
Stelljes, Matthias Finke, Juergen Koza, Vladimír Bornhaeuser, Martin Einsele, Hermann Socié, Gérard Zander, Axel R. Linkesch, Werner Heim, Dominik A. Bertz, Hartmut Maertens, Johan A. Schmoor, Claudia Kolbe, Karin Volin, Liisa Kolb, Hans-Jochem Ruutu, Tapani Ottinger, Hellmut D. Egger, Matthias Mayer, Jiří Bethge, Wolfgang A. Schwerdtfeger, Rainer Holler, Ernst Grishina, Olga
n3:wos
000291438000041
s:issn
0006-4971
s:numberOfPages
8
n12:doi
10.1182/blood-2011-01-329821