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

Abstract

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.

• Authors: Iu R Zalialov, A A Ganapiev, I K Golubovskaia, B V Afanas'ev
• Journal: Terapevticheskii arkhiv (Ter Arkh) Vol. 82 Issue 8 Pg. 53-6 ( 2010) ISSN: 0040-3660 [Print] Russia (Federation)
• PMID: 20873247 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Chemical References

• Antilymphocyte Serum
• Immunosuppressive Agents

Topics

• Adolescent
• Adult
• Antilymphocyte Serum (administration & dosage, therapeutic use)
• Child
• Child, Preschool
• Disease-Free Survival
• Dose-Response Relationship, Drug
• Graft vs Host Reaction (drug effects, immunology)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Immunosuppressive Agents (administration & dosage, therapeutic use)
• Infant
• Leukemia, Myeloid, Acute (immunology, mortality, surgery)
• Middle Aged
• Recurrence
• Remission Induction
• Transplantation Conditioning (methods)
• Transplantation, Homologous
• Young Adult