論文

査読有り 国際誌
2020年7月5日

Low-dose anti-thymocyte globulin for GVHD prophylaxis in HLA-matched allogeneic peripheral blood stem cell transplantation.

Bone marrow transplantation
  • Souichi Shiratori
  • ,
  • Junichi Sugita
  • ,
  • Shuichi Ota
  • ,
  • Senji Kasahara
  • ,
  • Jun Ishikawa
  • ,
  • Takayoshi Tachibana
  • ,
  • Yoshiki Hayashi
  • ,
  • Goichi Yoshimoto
  • ,
  • Tetsuya Eto
  • ,
  • Hiromi Iwasaki
  • ,
  • Mine Harada
  • ,
  • Keitaro Matsuo
  • ,
  • Takanori Teshima

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1038/s41409-020-0985-3

Allogeneic peripheral blood stem cell transplantation (PBSCT) is associated with an increased risk of severe acute and chronic graft-versus-host disease (GVHD) compared to bone marrow transplantation. Anti-thymocyte globulin (ATG) can reduce severe acute and chronic GVHD in PBSCT; however, an optimal dose of ATG remains undefined. We conducted a multicenter phase II study to investigate safety and efficacy of low-dose ATG (a total of 2 mg/kg Thymoglobulin) in patients undergoing HLA-matched PBSCT after myeloablative conditioning. The primary endpoint was grades III-IV GVHD at 100 days. Seventy-seven patients were enrolled and 72 patients with a median age of 46.5 years were eligible for analysis. The primary endpoint, cumulative incidence of grades III-IV acute GVHD at 100 days was 1.4% (95% CI, 0.1-6.7%), which was greatly less than our pre-defined statistical threshold value (18.0%). The incidence of chronic GVHD at 1 year was also low (all-grade; 15.3%, moderate to severe; 5.6%). Non-relapse mortality, relapse, overall survival, disease-free survival, and GVHD-free, relapse-free survival at 1 year were 4.2%, 20.8%, 84.7%, 75.0%, and 69.4%, respectively. Low dose thymoglobulin is promising to reduce severe acute and chronic GVHD in HLA-matched PBSCT following myeloablative conditioning.

リンク情報
DOI
https://doi.org/10.1038/s41409-020-0985-3
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32624582

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