Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation?.
- Author:
Young Sok JI
1
;
Min Sung LEE
;
Chang Wook MIN
;
Seong Kyu PARK
;
Se Hyung KIM
;
Jina YUN
;
Hyun Jung KIM
;
Kyoung Ha KIM
;
Chan Kyu KIM
;
Kyu Taek LEE
;
Jong Ho WON
;
Dae Sik HONG
Author Information
- Publication Type:Original Article
- Keywords: Antithymocyte globulin; Graft vs host disease; Related donor; Hematopoietic stem cell transplantation; Fludarabine
- MeSH: Antilymphocyte Serum*; Disease-Free Survival; Follow-Up Studies; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation*; Hematopoietic Stem Cells*; Humans; Incidence; Leukocytes; Mortality; Recurrence; Survival Rate; Tissue Donors*
- From:The Korean Journal of Internal Medicine 2016;31(4):750-761
- CountryRepublic of Korea
- Language:English
- 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.
