Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation?
- 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.
- All Author(s)
- Y. S. Ji
; M. S. Lee
; C. W. Min
; S. K. Park
; S. H. Kim
; J. Yun
; H. J. Kim
; K. H. Kim
; C. K. Kim
; K. T. Lee
; J. H. Won
; D. S. Hong
- Issued Date
- 2016
- Type
- Article
- Keyword
- Antithymocyte globulin; Graft vs host disease; Related donor; Hematopoietic stem cell transplantation; Fludarabine
- Publisher
- 대한내과학회
Korean Association of Internal Medicine
- ISSN
- 1226-3303
; 2005-6648
- Citation Title
- The Korean journal of internal medicine
- Citation Volume
- 31
- Citation Number
- 4
- Citation Start Page
- 750
- Citation End Page
- 761
- Language(ISO)
- eng
- DOI
- 10.3904/kjim.2015.234
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3231
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