References of "Mohty, M"
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See detailAllogeneic hematopoietic stem cell transplantation in solid organ transplant recipients: a retrospective, multicenter study of the EBMT
Basak, GW.; Wiktor-Jedrzejczak, W.; Labopin, M. et al

in American Journal of Transplantation (in press)

We conducted a questionnaire survey of the 565 European Society for Blood and Marrow Transplantation centers to analyze the outcome of allogeneic hematopoietic stem cell transplantation (alloSCT) in ... [more ▼]

We conducted a questionnaire survey of the 565 European Society for Blood and Marrow Transplantation centers to analyze the outcome of allogeneic hematopoietic stem cell transplantation (alloSCT) in recipients of solid organ transplantation (SOT). We investigated 28 patients with malignant (N=22) or nonmalignant diseases (N=6), who underwent 31 alloSCT procedures: 12 after kidney, 13 after liver, and three after heart transplantation. The incidence of solid organ graft failure at 60 months after first alloSCT was 33% (95% confidence interval [CI], 16–51%) for all patients, 15% (95% CI, 2–40%) for liver recipients, and 50% (95% CI, 19–75%) for kidney recipients (p = 0.06). The relapse rate after alloSCT (22%) was low following transplantation for malignant disorders, despite advanced stages of malignancy. Overall survival at 60 months after first alloSCT was 40% (95% CI, 19–60%) for all patients, 51% (95% CI, 16–86%) for liver recipients, and 42% (95% CI, 14–70%) for kidney recipients (p = 0.39). In summary, we show that selected SOT recipients suffering from hematologic disorders may benefit from alloSCT and experience enhanced long-term survival without loss of organ function. [less ▲]

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See detailOutcomes of adults with active or progressive hematological malignancies at time of allogeneic stem cell transplantation : a survey from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)
Chevallier, P.; Labopin, M.; Milpied, N. et al

in Bone Marrow Transplantation (2014), 49

Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective ... [more ▼]

Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)¼0.82; 95% confidence interval (CI), 0.69–0.98, P¼0.03; and HR¼0.79; 95% CI, 0.66–0.93, P¼0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR¼0.55; 95% CI, 0.45–0.68, Po0.0001; HR¼0.49; 95% CI, 0.31–0.75, P¼0.001; and HR¼0.47; 95% CI, 0.35–0.63, Po0.0001, respectively). In conclusion, this study suggests that allo-SCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT. [less ▲]

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See detailImpact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning all-SCT from a HLA-identical sibling donor : a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation
Baron, Frédéric ULg; Labopin, M.; Blaise, D. et al

in Bone Marrow Transplantation (2014)

The impact of in vivo T-cell depletion on transplantation outcomes in patients transplanted with reduced-intensity conditioning (RIC) remains controversial. This study assessed the outcome of 1250 adult ... [more ▼]

The impact of in vivo T-cell depletion on transplantation outcomes in patients transplanted with reduced-intensity conditioning (RIC) remains controversial. This study assessed the outcome of 1250 adult patients with de novo AML in first CR (CR1) given PBSC from HLA-identical siblings after chemotherapy-based RIC. A total of 554 patients did not receive any form of in vivo T-cell depletion (control group), whereas antithymocyte globulin (ATG) and alemtuzumab were given in 444 and 252 patients, respectively. The incidences of grade II-IV acute GVHD were 21.4, 17.6 and 10.2% in control, ATG and alemtuzumab patients, respectively (Po0.001). In multivariate analysis, the use of ATG and the use of alemtuzumab were each associated with a lower risk of chronic GVHD (Po0.001 each), but a similar risk of relapse, and of nonrelapse mortality, and similar leukemia-free survival and OS. Further, among patients given BU-based RIC, the use of o6 mg/kg ATG did not increase the risk of relapse (hazard ratio, HR¼1.1), whereas there was a suggestion for higher relapse risk in patients given X6 mg/kg ATG (HR¼1.4, P¼0.08). In summary, these data suggest that a certain amount of in vivo T-cell depletion can be safely used in the conditioning of AML patients in CR1 given PBSC after chemotherapy-based RIC. [less ▲]

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See detailImpact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia : a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation
Baron, Frédéric ULg; Labopin, M.; Niederwieser, D. et al

in Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K (2012), 26(12), 2462-2468

This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced ... [more ▼]

This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk of relapse (hazards ratio (HR)¼0.7, P¼0.02) translating into a trend for better overall survival (OS; HR¼1.3; P¼0.07). Grade II acute GVHD had no net impact on OS, while grade III–IV acute GVHD was associated with a worse OS (HR¼0.4, Po0.0.001) owing to high risk of nonrelapse mortality (NRM; HR¼5.2, Po0.0001). In time-dependent multivariate Cox analyses, limited chronic GVHD tended to be associated with a lower risk of relapse (HR¼0.72; P¼0.07) translating into a better OS (HR¼1.8; Po0.001), while extensive chronic GVHD was associated with a lower risk of relapse (HR¼0.65; P¼0.02) but also with higher NRM (HR¼3.5; Po0.001) and thus had no net impact on OS. In-vivo T-cell depletion with antithymocyte globulin (ATG) or alemtuzumab was successful at preventing extensive chronic GVHD (Po0.001), but without improving OS for ATG and even with worsening OS for alemtuzumab (HR¼0.65; P¼0.001). These results highlight the role of the immune-mediated graft-versus-leukemia effect in the RIC allo-SCT setting, but also the need for improving the prevention and treatment of severe GVHD. [less ▲]

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See detailImpact of chronic graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukaemia: A report from the Acute Leukaemia Working Party of the European Group for Blood and Marrow Transplantation
Baron, Frédéric ULg; Labopin, M.; Niederwieser, D. et al

Conference (2012)

We investigated the impact of occurrence of GVHD on transplantation outcomes in a large cohort of AML pts given allogeneic PBSC after RIC conditioning. Data from 1859 AML pts in fi rst (n=1439) or second ... [more ▼]

We investigated the impact of occurrence of GVHD on transplantation outcomes in a large cohort of AML pts given allogeneic PBSC after RIC conditioning. Data from 1859 AML pts in fi rst (n=1439) or second (n=420) CR transplanted between 2000 and 2009 following a RIC regimen at EBMT affi liated centres were analyzed. Pts were given PBSC from HLA-identical sibling (MRD, n=1208), or from HLA-matched unrelated donors (MUD, n=651). ATG was given in 269 (22%) MRD and in 267 (41%) MUD recipients, respectively, while 151 (13%) MRD and 165 (25%) MUD recipients received in-vivo T cell depletion with alemtuzumab. The impact of chronic GVHD (cGVHD) on outcomes was assessed using time-dependent multivariate Cox models and in a landmark analysis at 18 months after transplant. The 3-y cumulative incidence of cGVHD was 47%. Fifty-three percent of patients with cGVHD had extensive cGVHD, while the remaining 47% had limited cGVHD. In multivariate analyses, occurrence of grade II-IV aGVHD was associated with a lower risk of relapse (HR=0.8; P=0.04), a higher risk of chronic (HR=2.2; P<0.001) and extensive chronic GVHD (HR=2.8; P<0.001), a higher risk of NRM (HR=2.4 P<0.001), a worsened LFS (HR=1.3; P=0.01), and a worsened OS (HR=1.5; P<0.001). In multivariate time-dependent analyses, occurrence of limited cGVHD was associated with a lower risk of relapse (HR=0.7; P=0.05), comparable NRM (HR=1.4; P=0.16), comparable LFS (HR=0.9; P=0.29) and better OS (HR=0.5; P<0.001), while occurrence of extensive cGVHD was associated with a lower risk of relapse (HR=0.6; P=0.01), higher NRM (HR=3.2; P<0.001), a trend for worsened LFS (HR=1.3; P=0.06) and comparable OS (HR=0.9; P=0.34). In a landmark analysis in patients who were leukemia-free at 18 months after transplantation (n=776), 2-year relapse, NRM, LFS and OS were 16±2%, 2.5±1%, 82±2%, and 89±2%, respectively, in patients without cGVHD before the landmark time-point, versus 9±1% (P=0.001), 8±1% (P<0.001), 83±2% (P=0.65), and 86±2% (P=0.38), respectively, in patients with cGVHD before the landmark time-point. In conclusion, in this cohort of AML patients transplanted in remission, occurrence of cGVHD was associated with a lower risk of relapse that translated to better OS in patients with limited cGVHD but not in those with extensive cGVHD who experienced higher long term NRM. These results highlight the role of the GVT effect in RIC allo-SCT, but also the need for improving the prevention of severe cGVHD in pts receiving RIC allo-SCT. [less ▲]

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See detailImpact of alemtuzumab versus anti-thymocyte globulin after unrelated allogeneic stem cell transplantation with reduced-intensity conditioning as treatment for AML in CR1: a survey from the Acute Leukaemia Working Party of the EBMT
Baron, Frédéric ULg; Labopin, M.; Mufti, G. et al

Conference (2012)

In vivo T cell depletion of the graft with anti-thymocyte globulin (ATG) or with alemtuzumab has been frequently used in the setting of RIC allo-SCT from unrelated donors. This survey compared allo-SCT ... [more ▼]

In vivo T cell depletion of the graft with anti-thymocyte globulin (ATG) or with alemtuzumab has been frequently used in the setting of RIC allo-SCT from unrelated donors. This survey compared allo-SCT outcomes between 364 AML patients in first CR given unrelated PBSC after chemotherapy-based RIC and given either ATG (n=213) or alemtuzumab (n=151) in the conditioning regimen. Alemtuzumab patients were more frequently given grafts from HLA-mismatched donors (30% versus 16% having at least 1/10 HLA-mismatch with their donor, P=0.005), and were conditioned more often with melphalan-based RIC (62%), while ATG recipients were more frequently conditioned with busulfan-based RIC (84%). Median time to neutrophil engraftment (>500 ANC) was 16 days in ATG recipients, versus 12 days in alemtuzumab recipients (P<0.001). The incidence of grade II-IV acute GVHD was 28% in ATG recipients (9 patients with grade IV) and 24% (NS) in alemtuzumab recipients (2 patients with grade IV). Two-year incidences of chronic GVHD, relapse and NRM were 45%, 23% and 14%, respectively, in ATG recipients, and 47% (NS), 25% (NS) and 25% (P=0.008), respectively, in alemtuzumab recipients. Two-year OS and LFS were 69% and 63%, respectively, in ATG recipients, versus 55% (P=0.003) and 51% (P=0.02), respectively, in alemtuzumab recipients. Death from infection occurred in 7% of ATG recipients, versus 12% of alemtuzumab recipients. When the analysis was restricted to the 210 patients given grafts from 10/10 HLA-matched unrelated donors, the use of alemtuzumab (n=64) remained signifi cantly associated with higher NRM (22% vs 9%, P=0.007), lower LFS (58% vs 69%, P=0.07), and lower OS (62% vs 74%, P=0.04). In multivariate analyses (performed in patients given grafts from 10/10 HLA-matched donors), in comparison to the use of ATG, the use of alemtuzumab was associated with higher NRM (HR=2.5, P=0.025), a statistically non-signifi cant but higher relapse rate (HR=1.7, P=0.18), and signifi cantly worse LFS (HR=0.5, P=0.013) and OS (HR=0.4, P=0.002). In summary, this homogeneous cohort of AML patients transplanted in fi rst CR and given PBSC grafts from unrelated donors, the use of alemtuzumab in comparison with ATG was associated with worse LFS and OS. [less ▲]

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See detailUnrelated cord blood transplantation in adults with myelodysplasia or secondary acute myeloblastic leukemia : a survey on behalf of Eurocord and CLWP of EBMT
Robin, M.; Sanz, G. F.; Ionescu, I. et al

in Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K (2011), 25

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