Article (Scientific journals)
Immune Recovery after Allogeneic Hematopoietic Stem Cell Transplantation following Flu-TBI versus TLI-ATG Conditioning
HANNON, Muriel; BEGUIN, Yves; Ehx, Grégory et al.
2015In Clinical Cancer Research, 21 (14), p. 3131-9
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Keywords :
Immune reconstitution; Non-myeloablative conditioning; TBI; TLI; GVHD
Abstract :
[en] Purpose: A conditioning regimen for allogeneic hematopoietic cell transplantation (HCT) combining total lymphoid irradiation (TLI) plus anti-thymocyte globulin (ATG) has been develop to induce graft-versus-tumor effects without graft-versus-host disease (GVHD). Experimental Design: We compared immune recovery in 53 patients included in a phase II randomized study comparing nonmyeloablative HCT following either fludarabine plus 2 Gy total body irradiation (TBI arm, n=28) or 8 Gy TLI plus anti-thymocyte globulin (TLI arm, n=25). Results: In comparison to TBI patients, TLI patients had a similarly low 6-month incidence of grade II-IV acute GVHD, a lower incidence of moderate/severe chronic GVHD (P=0.02), a higher incidence of CMV reactivation (P<0.001), and a higher incidence of relapse (P=0.01). While recovery of total CD8+ T cells was similar in the two groups, with median CD8+ T cell counts reaching the normal values 40-60 days after allo-HCT, TLI patients had lower percentages of naïve CD8 T cells. Median CD4+ T cell counts did not reach the lower limit of normal values the first year after allo-HCT in the two groups. Further, CD4+ T cell counts were significantly lower in TLI than in TBI patients the first 6 months after transplantation. Interestingly, while median absolute regulatory T cell (Treg) counts were comparable in TBI and TLI patients, Treg/naïve CD4+ T cell ratios were significantly higher in TLI than in TBI patients the 2 first years after transplantation. Conclusions: Immune recovery differs substantially between these two conditioning regimens possibly explaining the different clinical outcomes observed (NCT00603954).
Disciplines :
Hematology
Author, co-author :
HANNON, Muriel ;  Centre Hospitalier Universitaire de Liège - CHU > Centre d'oncologie
BEGUIN, Yves  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Ehx, Grégory  ;  Université de Liège - ULiège > GIGA-R : Hématologie
SERVAIS, Sophie ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
SEIDEL, Laurence  ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'Informations médico économiques (SIME)
Graux, Carlos
Maertens, Johan
Kerre, Tessa
Daulne, Coline ;  Université de Liège - ULiège > GIGA-R : Hématologie
de Bock, Muriel
Fillet, Marianne ;  Université de Liège - ULiège > Département de pharmacie > Analyse des médicaments
ORY, Aurélie ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
WILLEMS, Evelyne ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
GOTHOT, André ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie biologique et immuno hématologie
Humblet-Baron, Stéphanie
BARON, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
More authors (6 more) Less
Language :
English
Title :
Immune Recovery after Allogeneic Hematopoietic Stem Cell Transplantation following Flu-TBI versus TLI-ATG Conditioning
Publication date :
15 July 2015
Journal title :
Clinical Cancer Research
ISSN :
1078-0432
eISSN :
1557-3265
Publisher :
American Association for Cancer Research, Inc. (AACR), Birmingham, United States - Alabama
Volume :
21
Issue :
14
Pages :
3131-9
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 07 May 2015

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