Myeloablative haploidentical hematopoietic stem cell transplantation using basiliximab for graft-versus-host disease prophylaxis.

Abstract

OBJECTIVES:

We retrospectively compared the prophylactic effect of basiliximab and antithymocyte globulin (ATG) after haploidentical hematopoietic stem cell transplantation (HSCT) in patients with leukemia.

METHODS:

Haploidentical HSCT using basiliximab for graft-versus-host disease (GVHD) prophylaxis in 10 patients with leukemia was retrospectively compared to ATG for GVHD prophylaxis in 24 patients.

RESULTS:

All the patients achieved neutrophil engraftment. One patient in the ATG group did not achieve platelet engraftment. The incidence of grade II-IV and grade III-IV acute GVHD was 30 and 20%, respectively, in the basiliximab group and 16.7 and 4.2%, respectively, in the ATG group (P > 0.05). Extensive cGVHD developed in 40 and 22.2% of patients in the basiliximab group and ATG group, respectively (P > 0.05). Basiliximab resulted in mild infection and a low incidence (10%) of infection-related mortality; ATG resulted in relative severe infection with 29.2% infection-related mortality (P > 0.05). During the follow-up period, 20% of the basiliximab group and 22.7% of the ATG group relapsed (P > 0.05). In the basiliximab group and the ATG group, the 3-year accumulative overall survival rate was, respectively, 80 and 52.5% and the 3-year leukemia-free survival, respectively, was 60 and 49.6% (P > 0.05).

DISCUSSION:

The incidences of grade II-IV and grade III-IV aGVHD in the basiliximab group were similar to those in halpoidentical HSCT containing ATG. Compared to the ATG group, the basiliximab group had a lower rate of transplantation-related mortality and better long-term survival, but without statistical significance.

CONCLUSION:

The prophylactic regimen of basiliximab with haploidentical HSCT against GVHD seems safe and promising. More studies needed to verify this.

• Authors: Rui Huang, Sanfang Tu, Lan Deng, Qian Kang, Chaoyang Song, Yuhua Li
• Journal: Hematology (Amsterdam, Netherlands) (Hematology) Vol. 20 Issue 6 Pg. 313-9 (Jul 2015) ISSN: 1607-8454 [Electronic] England
• PMID: 25321657 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Myeloablative Agonists
• Recombinant Fusion Proteins
• Basiliximab

Topics

• Adolescent
• Adult
• Antibodies, Monoclonal (administration & dosage, therapeutic use)
• Basiliximab
• Child
• Child, Preschool
• Female
• Graft vs Host Disease (genetics)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Male
• Middle Aged
• Myeloablative Agonists
• Recombinant Fusion Proteins (administration & dosage, therapeutic use)
• Retrospective Studies
• Transplantation Conditioning (methods)
• Transplantation, Homologous (methods)
• Young Adult