In vivo T cell depletion with pretransplant anti-thymocyte globulin reduces graft-versus-host disease without increasing relapse in good risk myeloid leukemia patients after stem cell transplantation from matched related donors.

Abstract

One-hundred and two patients with good risk myeloid leukemia (CML first chronic phase or AML first CR) were transplanted from HLA-related donors after conditioning with (n = 45) or without anti-thymocyte globulin (ATG) (n = 57). One graft failure was observed in the non-ATG and none in the ATG group. The median time to leukocyte engraftment (> 1 x 10(9)/l) was 16 (range 12-33) in the ATG group and 17 days (range 11-29) in the non-ATG group (NS) and for platelet engraftment (> 20 x 10(9)/l) 24 and 19 days (P = 0.002), respectively. Acute GVHD grade II-IV was observed in 47% of the non-ATG and in 20% of the ATG group (P = 0.004). Grade III/IV GVHD occurred in 7% of the ATG and in 32% of the non-ATG group (P = 0.002). Chronic GVHD was seen in 36% and 67% (P = 0.005), respectively. After a median follow-up of 48 months (range 2-128), the 5-year estimated OS is 66% (95% KI: 51-81%) for the ATG group and 59% (95% KI: 46-72%) for the non-ATG group (NS). The 5-year estimated DFS is 64% (95% KI: 50-78%) for ATG and 55% (95% KI: 43-67%) for the non-ATG regimen (NS). The 5-year probability of relapse was 5% in the ATG and 15% in the non-ATG group (NS). ATG as part of the conditioning regimen leads to a significant reduction in GVHD without increase of relapse in patients with myeloid leukemia after stem cell transplantation from HLA-related donors.

• Authors: N Kröger, T Zabelina, W Krüger, H Renges, N Stute, J Rischewski, S Sonnenberg, F Ayuk, F Tögel, U Schade, H Fiegel, R Erttmann, C Löliger, A R Zander
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 29 Issue 8 Pg. 683-9 (Apr 2002) ISSN: 0268-3369 [Print] England
• PMID: 12180114 (Publication Type: Journal Article)

Chemical References

• Antilymphocyte Serum

Topics

• Adolescent
• Adult
• Antilymphocyte Serum (therapeutic use)
• Child
• Disease-Free Survival
• Female
• Graft vs Host Disease (etiology, immunology, prevention & control)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Leukemia, Myeloid, Acute (immunology, therapy)
• Leukemia, Myeloid, Chronic-Phase (immunology, therapy)
• Lymphocyte Depletion (methods)
• Male
• Middle Aged
• T-Lymphocytes (immunology)
• Tissue Donors
• Transplantation, Homologous