Low-dose thymoglobulin as second-line treatment for steroid-resistant acute GvHD: an analysis of the JSHCT View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-11-21

AUTHORS

M Murata, K Ikegame, Y Morishita, H Ogawa, K Kaida, H Nakamae, T Ikeda, T Nishida, M Inoue, T Eto, K Kubo, T Sakura, T Mori, N Uchida, T Ashida, Y Matsuhashi, Y Miyazaki, T Ichinohe, Y Atsuta, T Teshima

ABSTRACT

A nationwide retrospective study for the clinical outcomes of 99 patients who had received thymoglobulin at a median total dose of 2.5 mg/kg (range, 0.5–18.5 mg/kg) as a second-line treatment for steroid-resistant acute GvHD was conducted. Of the 92 evaluable patients, improvement (complete or partial response) was observed in 55 patients (60%). Multivariate analysis demonstrated that male sex and grade III and IV acute GvHD were associated with a lower improvement rate, whereas thymoglobulin dose (<2.0, 2.0–3.9 and ⩾4.0 mg/kg) was NS. Factors associated with significantly higher nonrelapse mortality included higher patient age (⩾50 years), grade IV acute GvHD, no improvement of GvHD and higher dose of thymoglobulin (hazard ratio, 2.55; 95% confidence interval, 1.34–4.85; P=0.004 for 2.0–3.9 mg/kg group and 1.79; 0.91–3.55; P=0.093 for ⩾4.0 mg/kg group). Higher dose of thymoglobulin was associated with a higher incidence of bacterial infections, CMV antigenemia and any additional infection. Taken together, low-dose thymoglobulin at a median total dose of 2.5 mg/kg provides a comparable response rate to standard-dose thymoglobulin reported previously, and <2.0 mg/kg thymoglobulin is recommended in terms of the balance between efficacy and adverse effects. More... »

PAGES

252-257

Journal

TITLE

Bone Marrow Transplantation

ISSUE

2

VOLUME

52

Author Affiliations

  • Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
  • Department of Internal Medicine, Holy Spirit Hospital, Nagoya, Japan
  • Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
  • Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
  • Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
  • Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
  • Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan
  • Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
  • Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
  • Department of Hematology, Toranomon Hospital, Tokyo, Japan
  • Division of Hematology and Rheumatology, Department of Internal Medicine, Kinki University, School of Medicine, Osakasayama, Japan
  • Department of Hematology, Kawasaki Medical School, Kurashiki, Japan
  • Department of Hematology, Oita Prefectural Hospital, Oita, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Department of Hematology, Hokkaido University Graduate School of Medical Science, Sapporo, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/bmt.2016.247

    DOI

    http://dx.doi.org/10.1038/bmt.2016.247

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1000740095

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27869808


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