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Reduced platelet transfusions and earlier platelet engraftment using alemtuzumab-based conditioning regimen in allogeneic stem cell transplantation

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

In patients undergoing allogeneic stem cell transplantation, conditioning regimens containing alemtuzumab instead of anti-thymocyte globulin (ATG) may result in an earlier platelet engraftment and a reduced number of platelet transfusions.

Methods

We performed a retrospective, single-center, case–control study analyzing time to engraftment and transfusion needs using alemtuzumab in comparison with ATG as part of conditioning protocol.

Results

Median values for time to platelet engraftment, number of transfused platelet concentrates and number of transfused red cell concentrates were 12 versus 19.5 days (p < 0.001), 2 versus 14 (p < 0.001) and 6 versus 14.5 (p = 0.003) in the alemtuzumab and ATG group. Time to leukocyte engraftment did not differ with median 15 days in both groups. Patients in the ATG group showed a significant higher decrease in platelet count during conditioning (68 vs. 29 %, p = 0.001), leading to significant lower median platelet counts at the day of stem cell infusion (38 vs. 95.5 Gpt/l, p = 0.008), and higher values for median C-reactive protein after first antibody infusion (69.0 vs. 43.6 mg/l, p = 0.001) compared with alemtuzumab group. Test for significance was done by using Wilcoxon rank-sum test. Subgroup analysis considering the type of ATG used (Thymoglobulin vs. ATG Fresenius) revealed that differences between alemtuzumab and ATG group were more due to effects of ATG Fresenius than Thymoglobulin.

Conclusions

The use of alemtuzumab in comparison with ATG as part of the conditioning regimen may be an approach to reduce the number of transfused platelet and red cell concentrates after allogeneic stem cell transplantation.

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Authors and Affiliations

  1. Department of Hematology, Oncology, Transplantation, University Medical Center, Ernst-Moritz-Arndt University, Greifswald, Germany

    Thomas Neumann, Meike Schulze, Anne F. Klenner, Christoph Busemann, Gottfried Dölken & William H. Krüger

  2. Department of Urology, University Medical Center, Ernst-Moritz-Arndt University, Greifswald, Germany

    Laila Schneidewind

  3. Institute of Immunology and Transfusion Medicine, University Medical Center, Ernst-Moritz-Arndt University, Greifswald, Germany

    Thomas Thiele & Andreas Greinacher

  4. Department of Hematology, Oncology, HELIOS Klinikum Bad Saarow, Bad Saarow, Germany

    Daniel Pink

Authors
  1. Thomas Neumann
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  2. Laila Schneidewind
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  3. Thomas Thiele
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  4. Meike Schulze
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  5. Anne F. Klenner
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  6. Christoph Busemann
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  7. Daniel Pink
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  8. Andreas Greinacher
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  9. Gottfried Dölken
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  10. William H. Krüger
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Correspondence to Thomas Neumann.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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Neumann, T., Schneidewind, L., Thiele, T. et al. Reduced platelet transfusions and earlier platelet engraftment using alemtuzumab-based conditioning regimen in allogeneic stem cell transplantation. J Cancer Res Clin Oncol 142, 1091–1097 (2016). https://doi.org/10.1007/s00432-016-2114-7

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  • DOI: https://doi.org/10.1007/s00432-016-2114-7

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