Role of antithymocyte globulin in reducing the incidence of complications after allogeneic hemopoietic cell transplantation


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Aim. To evaluate the efficacy of antithymocyte globulin (ATG) used in conditioning modes before allogeneic hemopoietic cell transplantation (allo-HCT) and its effect in reducing the incidence of posttransplantation complications.
Subjects and methods. The study assessed the results of 92 allo-HCTs depending on the presence or absence of ATG in conditioning modes, the doses of Atgam (60 mg/kg or more), the presence or absence of acute leukemia (AL) in remission before HCT.
Results. In patients with AL in remission receiving ATG in conditioning modes (Atgam 60 mg/kg or thymoglobulin 7.5 mg/kg), overall three-year survival was 60%. Increasing the dose of Atgam up to more than 60 mg/kg resulted in higher transplantation-associated mortality (TAM) rates than did with the Atgam dose of 60 mg/kg (p < 0.01).
Conclusion. Allo-HCT is the treatment of choice for patients with AL in the presence of an HLA-identical related or unrelated donor. The use of Atgam in a course dose of not more than 60 mg/kg or thymoglobulin 7.5 mg/kg in conditioning modes is associated with low TAM rates and higher overall survival in earlier-stage disease in complete clinical hematological remission as compared with those in patients with expanded-stage AL, rather than in AL in remission at the start of conditioning before HCT.

作者简介

Yu Zalyalov

Acad. I. P. Pavlov Saint Petersburg State Medical University

Кафедра гематологии, трансфузиологии и трансплантологииаспирант; Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова; Acad. I. P. Pavlov Saint Petersburg State Medical University

A Ganapiyev

Acad. I. P. Pavlov Saint Petersburg State Medical University

Кафедра гематологии, трансфузиологии и трансплантологиид-р мед. наук, проф; Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова; Acad. I. P. Pavlov Saint Petersburg State Medical University

I Golubovskaya

Acad. I. P. Pavlov Saint Petersburg State Medical University

Кафедра гематологии, трансфузиологии и трансплантологииаспирант; Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова; Acad. I. P. Pavlov Saint Petersburg State Medical University

B Afanasyev

Acad. I. P. Pavlov Saint Petersburg State Medical UniversityR. M. Gorbacheva Institute of Pediatric Hematology and Transplantology

Кафедра гематологии, трансфузиологии и трансплантологиид-р мед. наук, проф., зав. каф; Санкт-Петербургский государственный медицинский университет им. акад. И. П. ПавловаИнститут детской гематологии и трансплантологии им. Р. М. Горбачевой; Acad. I. P. Pavlov Saint Petersburg State Medical UniversityR. M. Gorbacheva Institute of Pediatric Hematology and Transplantology

参考

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