Clinical efficacy and safety of porcine antihuman lymphocyte immunoglobulin in alternative donor allogeneic hematopoietic cell transplantation for severe aplastic anemia.
10.3760/cma.j.issn.0253-2727.2018.01.005
- Author:
Xin CHEN
1
;
Jia Lin WEI
;
Yong HUANG
;
Er Lie JIANG
;
Qiao Ling MA
;
Wei Hua ZHAI
;
Yi HE
;
Rong Li ZHANG
;
Dong Lin YANG
;
Jian Feng YAO
;
Gui Xin ZHANG
;
Si Zhou FENG
;
Ming Zhe HAN
Author Information
1. Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, 300020 Tianjin, China.
- Publication Type:Journal Article
- Keywords:
Anemia, aplastic, severe;
Donor, alternative;
Hematopoietic stem cell transplantation;
Porcine antihuman lymphocyte immunoglobulin
- MeSH:
Anemia, Aplastic/therapy*;
Animals;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Humans;
Lymphocytes;
Prospective Studies;
Rabbits;
Retrospective Studies;
Swine;
Treatment Outcome
- From:
Chinese Journal of Hematology
2018;39(1):22-27
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare eficacy and safety of porcine antihuman lymphocyte immunoglobulin (pALG) and rabbit antithymocyte immunoglobulin (rATG) as a part of alternative donor allogeneic hematopoietic stem cell transplantation (AD allo-HSCT) for severe aplastic anemia (SAA). Methods: The clinical data of 46 SAA patients received AD allo-HSCT from January 2006 to November 2016 were retrospectively analyzed. The cohort of patients were divided into two groups based on rATG or pALG as a part of conditioning regimen to compare implantation rate, transplantation related complications and outcome. Results: In rATG group 30 patients achieved ANC reconstitution, 27 patients achieved PLT reconstitution. In pALG group all 16 patients achieved ANC and PLT reconstitutions. There were no significant differences between the two groups in terms of acute graft-versus-host disease (aGVHD) (P=0.475), Ⅲ-Ⅳ grade aGVHD (P=0.876), chronic GVHD (cGVHD) (P=0.309), extensive cGVHD (P=0.687), graft rejection (GR) (P=0.928), bloodstream infection (P=0.443), invasive fungal disease (P=0.829), cytomegalovirus viremia (P=0.095) respectively. Prospective 5-year overall survival (OS) in rATG and pALG groups were (75.1±8.2)% and (53.6±13.3)% with median follow-up of 14(2-102) and 23(4-63) months, respectively (P=0.190). Conclusion: As a part of conditioning regimen, pALG could achieve similar efficacy as rATG, without increasing the incidences of transplantation complications such as GVHD, GR and infection, in the setting of AD allo-HSCT for SAA patients.
