Lower dose of antithymocyte globulin does not increase graft-versus-host disease in patients undergoing reduced-intensity conditioning allogeneic hematopoietic stem cell transplant. Leuk Lymphoma 2015 Apr;56(4):1058-65
Date
08/29/2014Pubmed ID
25166008Pubmed Central ID
PMC4417073DOI
10.3109/10428194.2014.956314Scopus ID
2-s2.0-84929086102 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
The appropriate dose of antithymocyte globulin (ATG) to be utilized in reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplant (alloHSCT) is as yet unknown. We retrospectively compared patients who received 7.5 mg/kg (R-ATG, 39 patients) and 6 mg/kg (r-ATG, 97 patients). The cumulative incidences of acute graft-versus-host disease (aGVHD) grade II-IV at 180 days were 46% and 41% and of aGVHD grade III-IV were 11% and 18% in r-ATG and R-ATG, respectively (p > 0.30). The respective estimated cumulative incidences at 24 months of cGVHD were 42% and 44% (p > 0.30). There was no significant difference in non-relapse mortality (p = 0.22), cumulative incidence of relapse (p = 0.53), progression-free survival (p = 0.69) or overall survival (p = 0.95). In conclusion, a decreased ATG dose of 6 mg/kg was associated with a similar proportion of GVHD to 7.5 mg/kg ATG. Given the increasing number of RIC HSCTs performed worldwide, the correct dose and preparation of ATG should be defined by prospective randomized trials.
Author List
Salem G, Ruppert AS, Elder P, Hofmeister CC, Benson DM, Penza S, Andritsos L, Klisovic R, Vasu S, Blum W, Devine SM, Jaglowski S, Efebera YAAuthor
Samantha M. Jaglowski MD, MPH Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Antilymphocyte Serum
Busulfan
Disease-Free Survival
Dose-Response Relationship, Drug
Female
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Recurrence
Retrospective Studies
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Vidarabine
Young Adult
