Antithymocyte globulin improves GVHD-free and relapse-free survival in unrelated hematopoietic stem cell transplantation
Antithymocyte globulin improves GVHD-free and relapse-free survival in unrelated hematopoietic stem cell transplantation
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抗胸腺细胞球蛋白可改善无关造血干细胞移植中的无 GVHD 和无复发生存
DOI：
10.1038/s41409-019-0502-8
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发表时间：
2019-03
影响因子：
4.8
通讯作者：
Huang He
中科院分区：
文献类型：
--
作者：
Luo Yi;Jin Mengqi;Tan Yamin;Zhao Yanmin;Shi Jimin;Zhu Yuanyuan;Zheng Weiyan;Lai Xiaoyu;Yu Jian;Huang He
抗胸腺细胞球蛋白(ATG)是预防非亲缘造血干细胞移植(HSCT)移植物抗宿主病(GVHD)预适应方案的重要组成部分，但ATG的最佳剂量尚不清楚。我们前瞻性地分析了205例恶性血液病患者中无关的HSCT。HSCT分为： 相合的无抗凝血球蛋白供者53例(A组)，经6 mg/kg胸腺球蛋白治疗的 不合供者77例(B组)，应用4.5 mg/kg胸腺球蛋白的 供者75例(C组)。A组和B组的5年中、重度慢性移植物抗宿主病发生率分别为31.9%和24.2%，5年无移植物抗宿主病和无复发生存率分别为28.3%和47%，2年无免疫抑制治疗生存率分别为8.6%和40.2%(P= 0.0016)。C组II-IV级急性移植物抗宿主病(GVHD)发生率(18.7%)和5年中重度慢性移植物抗宿主病(16.6%)发生率均低于A组。C组5年无瘤生存率(52.1%vs 28.3%，p= 0.002)、2年无瘤生存率(51.7%vs 8.6%，p= 0.00004)和5年总生存率(OS)(68.3%vs 41.5%，p= 0.007)高于A组。因此，在无关的HSCT中，ATG与更好的GVHD预防、更高的无IST存活率、更低的移植相关死亡率(TRM)以及更好的OS和GRFS相关。
Antithymocyte globulin (ATG) is an important component of conditioning regimens to prevent graft-versus-host disease (GVHD) in unrelated hematopoietic stem cell transplantation (HSCT), but the optimal dose of ATG remains unknown. We prospectively analyzed 205 unrelated HSCTs in patients with malignant hematological disorders. HSCTs were classified as follows: HLA-matched transplant without ATG (n= 53, group A), HLA-mismatched transplant treated with 6.0 mg/kg thymoglobulin (n= 77, group B), and HLA-matched transplant treated with 4.5 mg/kg thymoglobulin (n= 75, group C). For groups A and B, the 5-year moderate/severe chronic GVHD rates were 31.9% and 24.2%, the 5-year GVHD-free and relapse-free survival (GRFS) rates were 28.3 and 47%, and the 2-year immunosuppressive therapy (IST)-free survival rates were 8.6% and 40.2% (p= 0.0016), respectively. Furthermore, group C had lower incidences of grade II-IV acute GVHD (18.7%) and 5-year moderate/severe chronic GVHD (16.6%) than group A did. Group C had higher 5-year GRFS (52.1% vs 28.3%,p= 0.002), 2-year IST-free survival (51.7% vs 8.6%,p= 0.00004), and 5-year overall survival (OS) (68.3% vs 41.5%,p= 0.007) rates than group A did. Thus, ATG was associated with better GVHD prevention, a higher rate of IST-free survival, lower transplant-related mortality (TRM), and superior OS and GRFS in unrelated HSCTs.
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影响因子：
4.8
作者：
Kharfan-Dabaja, M. A.;Parody, R.;Perez-Simon, J. A.
通讯作者：
Perez-Simon, J. A.
影响因子：
51.1
作者：
Finke, Juergen;Bethge, Wolfgang A.;Socie, Gerard
通讯作者：
Socie, Gerard
影响因子：
6.2
作者：
GLUCKSBERG, H;STORB, R;THOMAS, ED
通讯作者：
THOMAS, ED
非操作、单倍相合造血干细胞移植预处理方案中兔胸腺球蛋白的最佳剂量：一项前瞻性随机试验的长期结果。
影响因子：
6.2
作者：
Chang, Ying-Jun;Wang, Yu;Huang, Xiao-Jun
通讯作者：
Huang, Xiao-Jun
影响因子：
4.3
作者：
Bryant, Adam;Mallick, Ranjeeta;Kekre, Natasha
通讯作者：
Kekre, Natasha