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Low-dose antithymocyte globulin inhibits chronic graft-versus-host disease in peripheral blood stem cell transplantation from unrelated donors

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Title: Low-dose antithymocyte globulin inhibits chronic graft-versus-host disease in peripheral blood stem cell transplantation from unrelated donors
Authors: Shiratori, Souichi Browse this author →KAKEN DB
Sugita, Junichi Browse this author
Fuji, Shigeo Browse this author
Aoki, Jun Browse this author
Sawa, Masashi Browse this author
Ozawa, Yukiyasu Browse this author
Hashimoto, Daigo Browse this author
Matsuoka, Ken-ichi Browse this author
Imada, Kazunori Browse this author
Doki, Noriko Browse this author
Ashida, Takashi Browse this author
Ueda, Yasunori Browse this author
Tanaka, Masatsugu Browse this author
Sawayama, Yasushi Browse this author
Ichinohe, Tatsuo Browse this author
Terakura, Seitaro Browse this author
Morishima, Satoko Browse this author
Atsuta, Yoshiko Browse this author
Fukuda, Takahiro Browse this author
Teshima, Takanori Browse this author →KAKEN DB
Issue Date: Sep-2021
Publisher: Springer Nature
Journal Title: Bone marrow transplantation
Volume: 56
Start Page: 2231
End Page: 2240
Publisher DOI: 10.1038/s41409-021-01314-w
Abstract: Antithymocyte globulin (ATG) has been shown to reduce chronic graft-versus-host disease (GVHD) particularly in allogeneic peripheral blood stem cell transplantation (PBSCT) from unrelated donors; however, anti-GVHD effects of lower doses of ATG remains to be elucidated. We conducted a nationwide retrospective study to compare the outcomes of unrelated PBSCT with or without rabbit ATG (thymoglobulin) in 287 patients. A median ATG dose was 2.0 mg/kg. The primary endpoint, the cumulative incidence of moderate-severe chronic GVHD at 2 years was 22.1% in the ATG group, which was significantly less than that in the non-ATG group (36.3%, P = 0.025). The ATG group had a higher incidence of immunosuppressant discontinuation, GVHD-free, relapse-free survival, and moderate-severe chronic GVHD-free, relapse-free survival at 2 years compared to the non-ATG group. The incidences of grade III-IV aGVHD and moderate-severe chronic GVHD were significantly higher in patients with high absolute lymphocyte count (ALC) before the administration of ATG, whereas relapse rate was significantly higher in patients with low ALC before ATG. In conclusion, low-dose ATG effectively suppresses chronic GVHD in unrelated PBSCT, and ALC before ATG may be a potential predictor for GVHD and relapse.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 白鳥 聡一

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