Tags

Type your tag names separated by a space and hit enter

Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation?
Korean J Intern Med. 2016 Jul; 31(4):750-61.KJ

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.

Authors+Show Affiliations

Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27017944

Citation

Ji, Young Sok, et al. "Does Anti-thymocyte Globulin Have a Place in Busulfan/fludarabine Conditioning for Matched Related Donor Hematopoietic Stem Cell Transplantation?" The Korean Journal of Internal Medicine, vol. 31, no. 4, 2016, pp. 750-61.
Ji YS, Lee MS, Min CW, et al. Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation? Korean J Intern Med. 2016;31(4):750-61.
Ji, Y. S., Lee, M. S., Min, C. W., Park, S. K., Kim, S. H., Yun, J., Kim, H. J., Kim, K. H., Kim, C. K., Lee, K. T., Won, J. H., & Hong, D. S. (2016). Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation? The Korean Journal of Internal Medicine, 31(4), 750-61. https://doi.org/10.3904/kjim.2015.234
Ji YS, et al. Does Anti-thymocyte Globulin Have a Place in Busulfan/fludarabine Conditioning for Matched Related Donor Hematopoietic Stem Cell Transplantation. Korean J Intern Med. 2016;31(4):750-61. PubMed PMID: 27017944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation? AU - Ji,Young Sok, AU - Lee,Min Sung, AU - Min,Chang Wook, AU - Park,Seong Kyu, AU - Kim,Se Hyung, AU - Yun,Jina, AU - Kim,Hyun Jung, AU - Kim,Kyoung Ha, AU - Kim,Chan Kyu, AU - Lee,Kyu-Taek, AU - Won,Jong-Ho, AU - Hong,Dae Sik, Y1 - 2016/03/28/ PY - 2015/07/22/received PY - 2015/09/06/revised PY - 2015/09/13/accepted PY - 2016/3/29/entrez PY - 2016/3/29/pubmed PY - 2017/5/16/medline KW - Antithymocyte globulin KW - Fludarabine KW - Graft vs host disease KW - Hematopoietic stem cell transplantation KW - Related donor SP - 750 EP - 61 JF - The Korean journal of internal medicine JO - Korean J. Intern. Med. VL - 31 IS - 4 N2 - 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. SN - 2005-6648 UR - https://www.unboundmedicine.com/medline/citation/27017944/Does_anti_thymocyte_globulin_have_a_place_in_busulfan/fludarabine_conditioning_for_matched_related_donor_hematopoietic_stem_cell_transplantation L2 - https://dx.doi.org/10.3904/kjim.2015.234 DB - PRIME DP - Unbound Medicine ER -