Zalialov Iu R, Ganapiev A A, Golubovskaia I K, Afanas'ev B V
Ter Arkh. 2010;82(8):53-6.
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.
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.
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).
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.
评估抗胸腺细胞球蛋白（ATG）在异基因造血细胞移植（allo-HCT）前预处理方案中的疗效及其对降低移植后并发症发生率的影响。
该研究根据预处理方案中是否使用ATG、Atgam的剂量（60mg/kg或更高）、HCT前急性白血病（AL）是否处于缓解期，评估了92例allo-HCT的结果。
处于缓解期的AL患者在预处理方案中接受ATG（Atgam 60mg/kg或兔抗人胸腺细胞球蛋白7.5mg/kg）治疗，总体三年生存率为60%。将Atgam剂量增加至超过60mg/kg会导致移植相关死亡率（TAM）高于Atgam剂量为60mg/kg时（p<0.01）。
对于有HLA相合同胞或无关供者的AL患者，allo-HCT是首选治疗方法。与处于进展期AL患者相比，在完全临床血液学缓解的早期疾病中，预处理方案中使用不超过60mg/kg的Atgam疗程剂量或7.5mg/kg的兔抗人胸腺细胞球蛋白与较低的TAM率和较高的总体生存率相关，而不是在HCT前预处理开始时处于缓解期的AL患者。
