A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors
A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors
复制标题
DOI：
10.1111/ctr.12131
复制
发表时间：
2013-07-01
影响因子：
2.1
通讯作者：
Mattsson, Jonas
中科院分区：
文献类型：
--
作者：
Remberger, Mats;Ringden, Olle;Mattsson, Jonas
该研究纳入了110例连续的血液恶性肿瘤患者，这些患者接受了基于氟达拉滨的降低强度预处理（RIC）和来自匹配的无关供体的造血干细胞移植（HSCT）。中位年龄为55岁（范围11-68岁），除15例患者外，所有患者均接受外周血干细胞移植。根据方案，对所有患者给予总剂量为6 mg/kg（n=66）或8 mg/kg（n=44）的抗胸腺细胞球蛋白（ATG）（Thymoglobulin，Genzyme）。ATG剂量不影响中性粒细胞或血小板植入时间。在接受6和8 mg/kg ATG的患者中，急性GVHD II-IV级的发生率分别为34%和18%（p=0.11），慢性GVHD的发生率分别为40%和26%（p=0.46）。给予低剂量和高剂量ATG的患者的5年无复发生存率（RFS）分别为61%和36%（p=0.14）。在给予低剂量ATG的患者中，复发率低于给予高剂量ATG的患者，19% vs. 41%（p=0.04）。多因素分析中年龄> 50岁（p
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 55yr (range 11-68) and all but 15 patients received peripheral blood stem cell grafts. Antithymocyte globulin (ATG) (Thymoglobulin, Genzyme) at a total dose of 6mg/kg (n=66) or 8mg/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 8mg/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 >50yr (p