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Pediatric Transplants

HLA-matched sibling stem cell transplantation in children with β-thalassemia with anti-thymocyte globulin as part of the preparative regimen: the Greek experience

Bone Marrow Transplantation volume 47, pages 1061–1066 (2012)Cite this article

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Abstract

BU combined with CY, the preferred preparatory regimen for thalassemic patients, is associated with a substantial incidence of graft rejection especially in patients with advanced disease stage. This study retrospectively analyzes the outcome of 75 consecutive pediatric patients with β-thalassemia who underwent HLA-matched sibling transplantation after anti-thymocyte globulin (ATG)-containing myeloablative conditioning regimens. With a median follow-up of 9 years (range 1–15 years), the overall survival (OS) and thalassemia free survival (TFS) rates were 96% and 92%, respectively. Both the estimated TRM and the cumulative incidence of rejection/failure were 4%. The cumulative incidences of acute GVHD grade II–III and grade III were 20% and 5.3%, respectively. No patient developed acute GVHD grade IV. Only two patients developed extensive chronic GVHD. The estimated OS and TFS for patients with Class 1 and 2 disease according to Pesaro criteria were 96.3% and 94.4%, whereas for patients with Class 3 disease they were 94.1% and 88.2%, respectively. In our series, the use of myeloablative conditioning regimens, which include ATG for the transplantation of thalassemic children from matched sibling donors, resulted in excellent outcomes with very low incidences of TRM and rejection.

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Acknowledgements

Wethank all the physicians and nurses of their SCT-unit for their dedicated work, and Drs Vasilis Ladis and Markissia Karagiorga for referring patients for transplantation. We also thank Dr Panagiotis Tsirigotis for reviewing the manuscript and multiple fruitful discussions.

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  1. E Goussetis and I Peristeri: These authors contributed equally to this work.

Authors and Affiliations

  1. Stem Cell Transplant Unit, Aghia Sophia Children's Hospital, Thivon and Papadiamantopoulou, Athens, Greece

    E Goussetis, I Peristeri, V Kitra, G Vessalas, A Paisiou, M Theodosaki, E Petrakou, M N Dimopoulou & S Graphakos

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Correspondence to E Goussetis.

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Goussetis, E., Peristeri, I., Kitra, V. et al. HLA-matched sibling stem cell transplantation in children with β-thalassemia with anti-thymocyte globulin as part of the preparative regimen: the Greek experience. Bone Marrow Transplant 47, 1061–1066 (2012). https://doi.org/10.1038/bmt.2011.219

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