Alemtuzumab with fludarabine and cyclophosphamide reduces chronic graft-versus-host disease after allogeneic stem cell transplantation for acquired aplastic anemia

Judith Marsh, Vikas Gupta, Ziyi Lim, Aloysius Y. Ho, Robin Ireland, Janet Hayden, Victoria Potter, Mickey B. Koh, M. Serajul Islam, Nigel Russell, David I. Marks, Ghulam J. Mufti, Tony Pagliuca

Research output: Contribution to journalArticlepeer-review

137 Citations (Scopus)

Abstract

We evaluated a novel alemtuzumab-based conditioning regimen in HSCT for acquired severe aplastic anemia (SAA). In a multicenter retrospective study, 50 patients received transplants from matched sibling donors (MSD; n = 21) and unrelated donors (UD; n = 29), using fludarabine 30 mg/m(2) for 4 days, cyclophosphamide 300 mg/m(2) for 4 days, and alemtuzumab median total dose of 60 mg (range: 40-100 mg). Median age was 35 years (range 8-62). Overall survival at 2 years was 95% +/- 5% for MSD and 83% for UD HSCT (p 0.34). Cumulative incidence of graft failure was 9.5% for MSD and 14.5% for UD HSCT. Full-donor chimerism (FDC) in unfractionated peripheral blood was 42%; no patient achieved CD3 FDC. Acute GVHD was observed in only 13.5% patients (all grade I-II) and only 2 patients (4%) developed chronic GVHD. A low incidence of viral infections was seen. Factors influencing overall survival were HSCT comorbidity 2-year index (92% with score 0-1 vs 42% with score >= 2, P <.001) and age (92% for age <50 years vs 71% >= 50 years, P <.001). Our data suggest that the use of an alemtuzumab-based HSCT regimen for SAA results in durable engraftment with a low incidence of chronic GVHD.
Original languageEnglish
Pages (from-to)2351 - 2357
Number of pages7
JournalBlood
Volume118
Issue number8
DOIs
Publication statusPublished - 25 Aug 2011

Fingerprint

Dive into the research topics of 'Alemtuzumab with fludarabine and cyclophosphamide reduces chronic graft-versus-host disease after allogeneic stem cell transplantation for acquired aplastic anemia'. Together they form a unique fingerprint.

Cite this