|
KMID : 0338420160310040750
|
|
The Korean Journal of Internal Medicine
2016 Volume.31 No. 4 p.750 ~ p.761
|
|
|
Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation?
|
|
Ji Young-Sok
Lee Min-Sung
Min Chang-wook
Park Seong-Kyu
Kim Se-Hyung
Yun Ji-Na
Kim Hyun-Jung
Kim Kyoung-Ha
Kim Chan-Kyu
Lee Kyu-Taek
Won Jong-Ho
Hong Dae-Sik
|
|
|
Abstract
|
|
|
Background/Aims: There is controversy about the prophylactic effect of anti-thymocyte globulin (ATG) on graft versus host disease (GVHD) in the setting of matched related-donor hematopoietic stem cell transplantation (HSCT). This study assessed the inf luences of ATG on the incidences of acute and chronic GVHD and other clinical outcomes in matched related-donor HSCT.
Methods: Sixty-one patients received allogeneic HSCT from human leukocyte antigen-matched, related donors. Patients received busulfan/fludarabine conditioning regimens and standard GVHD prophylaxis with or without additional ATG.
Results: There was no significant difference in the cumulative incidences of overall acute GVHD, grade II to IV acute GVHD at day 100, and chronic GVHD during the follow-up period between the ATG and non-ATG groups. Three-year overall survival rates were very similar, but three year disease-free survival of the non-ATG group was higher than that of the ATG group (56.2% for ATG vs. 63.1% for non-ATG, p = 0.597). Relapse rate at 3 years in the ATG group was slightly higher than that of the non-ATG group (37.5% vs. 20%, p = 0.29). Non-relapse mortality rate at 3 years was lower in the ATG group (6.25% vs. 15.6%, p = 0.668).
Conclusions: Although the addition of ATG doesn’t guarantee a reduction in the incidences of acute and chronic GVHD, pre-transplantation ATG may result in lower non-relapse mortality in the context of matched related-donor HSCT with a busulfan/fludarabine conditioning regimen. However, caution is needed when using ATG because of a possibility to increase relapse rate.
|
|
|
KEYWORD
|
|
|
Antithymocyte globulin, Graft vs host disease, Related donor, Hematopoietic stem cell transplantation, Fludarabine
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|