OBJECTIVE: In this study, we set out to evaluate the effect of three different antithymocyteglobulin (ATG) doses on graft failure and incidence of graft-vs-host disease (GVHD) among recipients of partially T-cell-depleted (TCD) grafts from matched unrelated donors (MUDs). PATIENTS AND METHODS: Data of 74 consecutively treated MUD recipients were analyzed. Fifty-two, 13, and 9 MUD patients were treated with ATG in a total dose of 8 mg/kg, 6 mg/kg, and 4 mg/kg (given from days -8 until -4), respectively. RESULTS: Granulocyte and platelet engraftment were not different between the groups, while graft failure was observed in two patients only (receiving 8 mg/kg and 4 mg/kg ATG, respectively). The cumulative incidence of severe (grade III-IV) acute GVHD and extensive chronic GVHD was 4%, 0%, 44% and 11%, 8%, 44% in groups receiving ATG in a dose of 8 mg/kg, 6 mg/kg, and 4 mg/kg, respectively (severe acute GVHD: p<0.001; extensive chronic GVHD: p=0.05). CONCLUSION: Based on these findings, we recommend when ATG is used in the setting of stem cell transplantation with (partially) TCD grafts from MUDs, to give a total dose of 6 to 8 mg/kg. A further decrease in dosage resulted in a highly significant increased incidence of severe acute and extensive chronic GVHD.
OBJECTIVE: In this study, we set out to evaluate the effect of three different antithymocyteglobulin (ATG) doses on graft failure and incidence of graft-vs-host disease (GVHD) among recipients of partially T-cell-depleted (TCD) grafts from matched unrelated donors (MUDs). PATIENTS AND METHODS: Data of 74 consecutively treated MUD recipients were analyzed. Fifty-two, 13, and 9 MUD patients were treated with ATG in a total dose of 8 mg/kg, 6 mg/kg, and 4 mg/kg (given from days -8 until -4), respectively. RESULTS: Granulocyte and platelet engraftment were not different between the groups, while graft failure was observed in two patients only (receiving 8 mg/kg and 4 mg/kg ATG, respectively). The cumulative incidence of severe (grade III-IV) acute GVHD and extensive chronic GVHD was 4%, 0%, 44% and 11%, 8%, 44% in groups receiving ATG in a dose of 8 mg/kg, 6 mg/kg, and 4 mg/kg, respectively (severe acute GVHD: p<0.001; extensive chronic GVHD: p=0.05). CONCLUSION: Based on these findings, we recommend when ATG is used in the setting of stem cell transplantation with (partially) TCD grafts from MUDs, to give a total dose of 6 to 8 mg/kg. A further decrease in dosage resulted in a highly significant increased incidence of severe acute and extensive chronic GVHD.
Authors: Mehdi Hamadani; William Blum; Gary Phillips; Patrick Elder; Leslie Andritsos; Craig Hofmeister; Lynn O'Donnell; Rebecca Klisovic; Sam Penza; Ramiro Garzon; David Krugh; Thomas Lin; Thomas Bechtel; Don M Benson; John C Byrd; Guido Marcucci; Steven M Devine Journal: Biol Blood Marrow Transplant Date: 2009-09-01 Impact factor: 5.742
Authors: R F Olsson; B R Logan; S Chaudhury; X Zhu; G Akpek; B J Bolwell; C N Bredeson; C C Dvorak; V Gupta; V T Ho; H M Lazarus; D I Marks; O T H Ringdén; M C Pasquini; J R Schriber; K R Cooke Journal: Leukemia Date: 2015-03-16 Impact factor: 11.528
Authors: Elias Hallack Atta; Danielli Cristina Muniz de Oliveira; Luis Fernando Bouzas; Márcio Nucci; Eliana Abdelhay Journal: PLoS One Date: 2014-09-04 Impact factor: 3.240