The following research abstracts were included in the May 2018 issue of ASBMT eNews. Read the full issue here.
Older AML Patients May Benefit From Treosulfan-Based Conditioning
According to a study published in Biology of Blood and Marrow Transplantation, outcomes after stem cell transplantation are similar after various conditioning regimens, but treosulfan-based conditioning is safe and effective for older adults with acute myeloid leukemia and results in lower rates of graft-versus-host disease. The study, conducted on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, compared outcomes after fludarabine with either intravenous busulfan at a myeloablative dose or a reduced dose or treosulfan at 42 g/m2 or 36 g/m2. The study included nearly 3,300 patients with a median age ranging from 48 to 60 years old. Outcomes were similar among the groups with two-year overall survival ranging from 51% to 58%, relapse ranging from 30% to 40% and non-relapse mortality ranging from 16% to 21%. Worse outcomes were more common for older patients with advanced disease. Among the researchers’ conclusions, survival is determined mostly by disease biology, but older patients may benefit from treosulfan-based conditioning because of lower rates of GVHD possibly better outcomes in patients with active leukemia. Read More
AAT Treats Steroid-Resistant Acute GVHD
Α naturally abundant serine protease inhibitor, α1-antitrypsin (AAT), safely and effectively treats acute graft-versus-host disease resistant to corticosteroids, according to results of a clinical trial appearing in Blood. For the study, researchers intravenously administered AAT twice a week for four weeks to 40 patients. They noted that the treatment was tolerated without any adverse events and that serum levels of ATT increased significantly. At the end of treatment, the overall response rate was 65% and the complete or partial response rate was 35%. Responses occurred in all target organs and were sustained in 73% of patients at day 60. Mortality occurred in 10% of patients at day 60 and in 2.5% of patients within 30 days of the last AAT infusion. Finally, samples indicated that the ratio of activated regulatory and effector T cells increased after AAT treatment, correlating with preclinical data. Read More
Brentuximab Vedotin Lowers Risk of Chronic GVHD
Patients treated with brentuximab vedotin (BV) prior to allogeneic stem cell transplantation for Hodgkin lymphoma have similar outcomes as patients not treated with the drug but do have a lower risk of developing chronic graft-versus-host disease (GVHD), reports a study from the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation. The study appearing in the British Journal of Haematology compared 210 patients who received BV prior to transplantation to 218 patients who did not receive the treatment. Approximately four years later, both groups had comparable disease status, performance status, comorbidities, prior autologous stem cell transplantation, type of donor, conditioning and in vivo T-cell depletion. BV treatment did not affect acute GVHD, non-relapse mortality, cumulative relapse occurrence, progression-free survival or overall survival, but it did significantly reduce the risk of chronic GVHD. This led researchers to conclude that although there are similar outcomes, BV may improve the success of allogeneic transplantation by helping otherwise refractory patients to achieve a more favorable disease status. Read More