Low-dose antithymocyte globulin inhibits chronic graft-versus-host disease in peripheral blood stem cell transplantation from unrelated donors View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-05-07

AUTHORS

Souichi Shiratori, Junichi Sugita, Shigeo Fuji, Jun Aoki, Masashi Sawa, Yukiyasu Ozawa, Daigo Hashimoto, Ken-ichi Matsuoka, Kazunori Imada, Noriko Doki, Takashi Ashida, Yasunori Ueda, Masatsugu Tanaka, Yasushi Sawayama, Tatsuo Ichinohe, Seitaro Terakura, Satoko Morishima, Yoshiko Atsuta, Takahiro Fukuda, Takanori Teshima

ABSTRACT

Antithymocyte globulin (ATG) has been shown to reduce chronic graft-versus-host disease (GVHD) particularly in allogeneic peripheral blood stem cell transplantation (PBSCT) from unrelated donors; however, anti-GVHD effects of lower doses of ATG remains to be elucidated. We conducted a nationwide retrospective study to compare the outcomes of unrelated PBSCT with or without rabbit ATG (thymoglobulin) in 287 patients. A median ATG dose was 2.0 mg/kg. The primary endpoint, the cumulative incidence of moderate–severe chronic GVHD at 2 years was 22.1% in the ATG group, which was significantly less than that in the non-ATG group (36.3%, P = 0.025). The ATG group had a higher incidence of immunosuppressant discontinuation, GVHD-free, relapse-free survival, and moderate–severe chronic GVHD-free, relapse-free survival at 2 years compared to the non-ATG group. The incidences of grade III–IV aGVHD and moderate–severe chronic GVHD were significantly higher in patients with high absolute lymphocyte count (ALC) before the administration of ATG, whereas relapse rate was significantly higher in patients with low ALC before ATG. In conclusion, low-dose ATG effectively suppresses chronic GVHD in unrelated PBSCT, and ALC before ATG may be a potential predictor for GVHD and relapse. More... »

PAGES

2231-2240

References to SciGraph publications

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  • Journal

    TITLE

    Bone Marrow Transplantation

    ISSUE

    9

    VOLUME

    56

    Author Affiliations

  • Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
  • Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
  • Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
  • Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
  • Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
  • Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
  • Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University Hospital, Osakasayama, Japan
  • Department of Hematology/Oncology and Transfusion and Hemapheresis Center, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
  • Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
  • Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-021-01314-w

    DOI

    http://dx.doi.org/10.1038/s41409-021-01314-w

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1137805404

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33963304


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