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Efficacy of antithymocyte globulin for allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis.
Leuk Lymphoma. 2017 08; 58(8):1840-1848.LL

Abstract

The efficacy of rabbit antithymocyte globulin (ATG) for the prevention of graft-versus-host disease (GVHD) has been evaluated in several randomized control trials, but the results show some discrepancies. Therefore, we performed a systematic review and meta-analysis covering the latest RCTs including six trials (total 845 patients). The incidence of acute and chronic GVHD was significantly lower in the ATG arms (risk ratio, 0.75 and 0.54, respectively). No significant differences were found regarding overall survival, the incidence of relapse, and non-relapse mortality; however, the incidence of cytomegalovirus and Epstein-Barr virus reactivation increased (risk ratio, 1.25 and 1.33), and neutrophil engraftment was significantly delayed (median, 2.66 days). In conclusion, rabbit ATG should be beneficial as a GVHD prophylaxis in addition to conventional regimens, with close monitoring of virus reactivation and enough attention to delayed engraftment. Studies comparing the timing and dosage of ATG are essential to determine the suitable prophylactic regimens.

Authors+Show Affiliations

a Department of Hematology and Oncology, Graduate School of Medicine , Kyoto University , Kyoto , Japan. b Laboratory of Host Defenses , National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda , MD , USA.a Department of Hematology and Oncology, Graduate School of Medicine , Kyoto University , Kyoto , Japan.a Department of Hematology and Oncology, Graduate School of Medicine , Kyoto University , Kyoto , Japan.a Department of Hematology and Oncology, Graduate School of Medicine , Kyoto University , Kyoto , Japan.a Department of Hematology and Oncology, Graduate School of Medicine , Kyoto University , Kyoto , Japan.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27951736

Citation

Arai, Yasuyuki, et al. "Efficacy of Antithymocyte Globulin for Allogeneic Hematopoietic Cell Transplantation: a Systematic Review and Meta-analysis." Leukemia & Lymphoma, vol. 58, no. 8, 2017, pp. 1840-1848.
Arai Y, Jo T, Matsui H, et al. Efficacy of antithymocyte globulin for allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis. Leuk Lymphoma. 2017;58(8):1840-1848.
Arai, Y., Jo, T., Matsui, H., Kondo, T., & Takaori-Kondo, A. (2017). Efficacy of antithymocyte globulin for allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis. Leukemia & Lymphoma, 58(8), 1840-1848. https://doi.org/10.1080/10428194.2016.1266624
Arai Y, et al. Efficacy of Antithymocyte Globulin for Allogeneic Hematopoietic Cell Transplantation: a Systematic Review and Meta-analysis. Leuk Lymphoma. 2017;58(8):1840-1848. PubMed PMID: 27951736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of antithymocyte globulin for allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis. AU - Arai,Yasuyuki, AU - Jo,Tomoyasu, AU - Matsui,Hiroyuki, AU - Kondo,Tadakazu, AU - Takaori-Kondo,Akifumi, Y1 - 2016/12/12/ PY - 2016/12/14/pubmed PY - 2018/1/13/medline PY - 2016/12/14/entrez KW - Graft-versus-host disease KW - allogeneic hematopoietic cell transplantation KW - antithymocyte globulin KW - meta-analysis SP - 1840 EP - 1848 JF - Leukemia & lymphoma JO - Leuk Lymphoma VL - 58 IS - 8 N2 - The efficacy of rabbit antithymocyte globulin (ATG) for the prevention of graft-versus-host disease (GVHD) has been evaluated in several randomized control trials, but the results show some discrepancies. Therefore, we performed a systematic review and meta-analysis covering the latest RCTs including six trials (total 845 patients). The incidence of acute and chronic GVHD was significantly lower in the ATG arms (risk ratio, 0.75 and 0.54, respectively). No significant differences were found regarding overall survival, the incidence of relapse, and non-relapse mortality; however, the incidence of cytomegalovirus and Epstein-Barr virus reactivation increased (risk ratio, 1.25 and 1.33), and neutrophil engraftment was significantly delayed (median, 2.66 days). In conclusion, rabbit ATG should be beneficial as a GVHD prophylaxis in addition to conventional regimens, with close monitoring of virus reactivation and enough attention to delayed engraftment. Studies comparing the timing and dosage of ATG are essential to determine the suitable prophylactic regimens. SN - 1029-2403 UR - https://www.unboundmedicine.com/medline/citation/27951736/Efficacy_of_antithymocyte_globulin_for_allogeneic_hematopoietic_cell_transplantation:_a_systematic_review_and_meta_analysis_ L2 - https://www.tandfonline.com/doi/full/10.1080/10428194.2016.1266624 DB - PRIME DP - Unbound Medicine ER -