Immune stimulation during chemotherapy increases incidence of acute graft versus host disease in acute myeloid leukemia: A study on behalf of SFGM-TC and ALFA

Lining Wang 1, 2, 3 Emmanuel Raffoux 4 Xavier Thomas 5 Ibrahim Yakoub-Agha 6 Jean-Henri Bouhris 7, 8 Stéphane De Botton 9, 7, 8 Mauricette Michallet 5 Stéphanie Nguyen Quoc 10 Sylvain Chantepie 11 Eric Deconinck 12 Denis Caillot 13 Pascal Turlure 14 Stéphane Vigouroux 15 Arnaud Pigneux 16 Anne Huynh 17 Jean-Valère Malfuson 18 Michael Loschi 19 Gerard Socie 4 Hervé Dombret 1 Régis Peffault De La Tour 1 Thomas Cluzeau 4, 20, *
* Auteur correspondant
1 Service d'hématologie greffe [Saint-Louis]
2 Shanghai Jiao Tong University [Shanghai]
3 Shanghai Institute of Hematology
4 Hôpital Saint-Louis
5 Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL]
6 CHU Lille
7 Département d'hématologie [Gustave Roussy]
8 Université Paris-Saclay
9 IGR - Institut Gustave Roussy
10 CHU Pitié-Salpêtrière [APHP]
11 IHBN - Institut d'Hématologie de Basse-Normandie
12 Laboratoire d'Hématologie
13 CHU Dijon
14 Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges]
15 Hôpital Haut-Lévêque [CHU Bordeaux]
16 Hôpital Haut-Lévêque
17 CHU de Toulouse; Service d'Hématologie
18 Hôpital d'Instruction des Armées Percy
19 CRLCC Henri Becquerel
20 C3M - Centre méditérannéen de médecine moléculaire
Abstract : 60-70% of AML patients have an indication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) during their treatment. Graft versus host disease (GvHD), the major cause of mortality and comorbidities post-transplantation, develops by immunological mechanism and decides greatly prognosis and quality of life (QoL) of graft recipient. Current GvHD prophylaxis is not personalized. Infections, toxicities and leukemic infiltration complicate the first chemotherapy phases prior to allo-HSCT. They, to certain extent, induce local immune stimulation. Impact of immune stimulation of this period on incidence of GvHD has not been evaluated. We retrospectively studied 238 AML patients transplanted at first remission from 21 French centers in the ALFA-0702 protocol and found that cutaneous and digestive immune stimulation during induction increases the incidence of skin and gut aGVHD, respectively. Furthermore, prolonged febrile duration correlates with elevated incidence of grade II-IV aGvHD. Thus, we identified a group of patients with higher risk of aGvHD. The benefit of personalized GvHD prophylaxis should be explored in a prospective cohort to decrease incidence of aGvHD in these patients and improve their QoLs.
Keywords : Infections Toxicities Transplantation AML GVHD
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Article dans une revue
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01557470
Contributeur : Lnc - Université de Bourgogne <>
Soumis le : jeudi 6 juillet 2017 - 12:00:57
Dernière modification le : mardi 5 juin 2018 - 10:14:43

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Lining Wang, Emmanuel Raffoux, Xavier Thomas, Ibrahim Yakoub-Agha, Jean-Henri Bouhris, et al.. Immune stimulation during chemotherapy increases incidence of acute graft versus host disease in acute myeloid leukemia: A study on behalf of SFGM-TC and ALFA. Leukemia Research, Elsevier, 2017, 54, pp.12-16. 〈http://www.sciencedirect.com/science/article/pii/S0145212617300024〉. 〈10.1016/j.leukres.2017.01.002〉. 〈hal-01557470〉

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