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A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors.
Clin Transplant. 2013 Jul-Aug; 27(4):E368-74.CT

Abstract

The study included 110 consecutive patients with hematological malignancies receiving fludarabine-based reduced intensity conditioning (RIC) and hematopoietic stem cell transplantation (HSCT) from matched unrelated donors. The median age was 55 yr (range 11-68) and all but 15 patients received peripheral blood stem cell grafts. Antithymocyte globulin (ATG) (Thymoglobulin, Genzyme) at a total dose of 6 mg/kg (n = 66) or 8 mg/kg (n = 44) was given to all patients according to protocol. The ATG dose did not affect time-to-neutrophil or platelet engraftment. The incidences of acute GVHD grades II-IV were 34% and 18% (p = 0.11) and of chronic GVHD were 40% and 26% (p = 0.46) in patients receiving 6 and 8 mg/kg of ATG, respectively. The five-yr relapse-free survival (RFS) was 61% and 36% (p = 0.14) in patients, given low and high ATG dose, respectively. In patients given low-dose ATG, the incidence of relapse was lower compared to those given high-dose ATG, 19% vs. 41% (p = 0.04). In multivariate analysis, age >50 yr (p < 0.001), absence of acute (p < 0.001) and chronic GVHD (p = 0.001) were correlated to relapse, and low-dose ATG was associated with improved RFS (p < 0.05). A high dose (8 mg/kg) of ATG in RIC HSCT with unrelated donors increased the risk for relapse and reduced the RFS.

Authors+Show Affiliations

Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden. Mats.remberger@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23701240

Citation

Remberger, Mats, et al. "A High Antithymocyte Globulin Dose Increases the Risk of Relapse After Reduced Intensity Conditioning HSCT With Unrelated Donors." Clinical Transplantation, vol. 27, no. 4, 2013, pp. E368-74.
Remberger M, Ringdén O, Hägglund H, et al. A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors. Clin Transplant. 2013;27(4):E368-74.
Remberger, M., Ringdén, O., Hägglund, H., Svahn, B. M., Ljungman, P., Uhlin, M., & Mattsson, J. (2013). A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors. Clinical Transplantation, 27(4), E368-74. https://doi.org/10.1111/ctr.12131
Remberger M, et al. A High Antithymocyte Globulin Dose Increases the Risk of Relapse After Reduced Intensity Conditioning HSCT With Unrelated Donors. Clin Transplant. 2013 Jul-Aug;27(4):E368-74. PubMed PMID: 23701240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors. AU - Remberger,Mats, AU - Ringdén,Olle, AU - Hägglund,Hans, AU - Svahn,Britt-Marie, AU - Ljungman,Per, AU - Uhlin,Michael, AU - Mattsson,Jonas, Y1 - 2013/05/22/ PY - 2012/11/26/accepted PY - 2013/5/25/entrez PY - 2013/5/25/pubmed PY - 2014/3/13/medline KW - MUD KW - allogeneic KW - antithymocyte globulin KW - hematopoietic stem cell transplantation KW - reduced intensity conditioning SP - E368 EP - 74 JF - Clinical transplantation JO - Clin Transplant VL - 27 IS - 4 N2 - The study included 110 consecutive patients with hematological malignancies receiving fludarabine-based reduced intensity conditioning (RIC) and hematopoietic stem cell transplantation (HSCT) from matched unrelated donors. The median age was 55 yr (range 11-68) and all but 15 patients received peripheral blood stem cell grafts. Antithymocyte globulin (ATG) (Thymoglobulin, Genzyme) at a total dose of 6 mg/kg (n = 66) or 8 mg/kg (n = 44) was given to all patients according to protocol. The ATG dose did not affect time-to-neutrophil or platelet engraftment. The incidences of acute GVHD grades II-IV were 34% and 18% (p = 0.11) and of chronic GVHD were 40% and 26% (p = 0.46) in patients receiving 6 and 8 mg/kg of ATG, respectively. The five-yr relapse-free survival (RFS) was 61% and 36% (p = 0.14) in patients, given low and high ATG dose, respectively. In patients given low-dose ATG, the incidence of relapse was lower compared to those given high-dose ATG, 19% vs. 41% (p = 0.04). In multivariate analysis, age >50 yr (p < 0.001), absence of acute (p < 0.001) and chronic GVHD (p = 0.001) were correlated to relapse, and low-dose ATG was associated with improved RFS (p < 0.05). A high dose (8 mg/kg) of ATG in RIC HSCT with unrelated donors increased the risk for relapse and reduced the RFS. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/23701240/A_high_antithymocyte_globulin_dose_increases_the_risk_of_relapse_after_reduced_intensity_conditioning_HSCT_with_unrelated_donors_ L2 - https://doi.org/10.1111/ctr.12131 DB - PRIME DP - Unbound Medicine ER -