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High lymphocyte counts before antithymocyte globulin administration predict acute graft-versus-host disease

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Title: High lymphocyte counts before antithymocyte globulin administration predict acute graft-versus-host disease
Authors: Shiratori, Souichi Browse this author →KAKEN DB
Ohigashi, Hiroyuki Browse this author →KAKEN DB
Ara, Takahide Browse this author
Yasumoto, Atsushi Browse this author →KAKEN DB
Goto, Hideki Browse this author →KAKEN DB
Nakagawa, Masao Browse this author →KAKEN DB
Sugita, Junichi Browse this author
Onozawa, Masahiro Browse this author →KAKEN DB
Kahata, Kaoru Browse this author
Endo, Tomoyuki Browse this author
Hashimoto, Daigo Browse this author →KAKEN DB
Teshima, Takanori Browse this author →KAKEN DB
Keywords: Allogeneic hematopoietic stem cell transplantation
Peripheral blood stem cell transplantation
Antithymocyte globulin
Graft-versus-host disease
Absolute lymphocyte count
Issue Date: May-2021
Publisher: Springer
Journal Title: Annals of hematology
Volume: 100
Issue: 5
Start Page: 1321
End Page: 1328
Publisher DOI: 10.1007/s00277-020-04347-1
Abstract: Antithymocyte globulin (ATG) reduces severe acute and chronic graft-versus-host disease (GVHD) in allogeneic peripheral blood stem cell transplantation (PBSCT). However, risk factors for severe acute GVHD in PBSCT using ATG remain to be determined. We conducted a single-center, retrospective study to analyze the association of acute GVHD requiring systemic corticosteroid (SC-aGVHD) with absolute lymphocyte counts (ALC) before the administration of ATG or conditioning in 53 patients with HLA-matched PBSCT using low-dose thymoglobulin (2 mg/kg) after myeloablative conditioning. The cumulative incidence of SC-aGVHD was 17.0% and ALC before ATG were significantly higher in patients with SC-aGVHD compared to that in patients without it (median, 0.15 x 10(9)/L vs 0.06 x 10(9)/L, P = 0.047). The cumulative incidence of SC-aGVHD was significantly higher in patients with high ALC before ATG (>= 0.15 x 10(9)/L) than in those with low ALC (38.5% vs 10.0%, P = 0.016). Non-relapse mortality (NRM) was also significantly higher in the high ALC before ATG group than the low ALC before ATG group (2-year NRM: 23.9% vs 6.0%, P = 0.048), leading to worse survival (2-year overall survival: 69.2% vs 83.5%, P = 0.039). Our study suggested that high ALC before ATG is a risk factor for SC-aGVHD.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Annals of Hematology. The final authenticated version is available online at:
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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