Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Biol Blood Marrow Transplant. 2012 May;18(5):754-62. doi: 10.1016/j.bbmt.2011.09.005. Epub 2011 Sep 29.
Basiliximab and daclizumab, two interleukin-2 receptor antagonists (IL-2RAs), prevent graft failure in renal transplantation, which also effectively treat steroid-refractory graft-versus-host disease (GVHD). However, only a few studies report that IL-2RAs prevent GVHD. Here we first retrospectively explored the prophylactic effects of basiliximab or daclizumab against GVHD in 82 patients with hematologic malignancies following unrelated donor-peripheral blood stem cell transplantation (URD-PBSCT). All recipients achieved engraftment. The rates of grade II-IV and III-IV acute GVHD (aGVHD) were 35.4% and 15.9%, respectively. Chronic GVHD (cGVHD) developed in 38.7% of evaluable patients. The transplantation-related mortality was 13.4%, while relapse rate was 8.5%. The 2-year overall survival (OS) reached 77.1% and disease-free survival (DFS) accumulated to 72.2%. The side effects of basiliximab and daclizumab were moderate and tolerable. There were no significant differences in aGVHD onset and survival between the daclizumab and basiliximab groups. However, basiliximab presented superior prophylactic effects on cGVHD than daclizumab. In conclusion, basiliximab or daclizumab prevents GVHD efficiently and feasibly following URD-PBSCT, and contributes to favorable outcome. Basiliximab has a similar effect on aGVHD but superior activity against cGVHD. Further prospective and randomized control studies are needed.
巴利昔单抗和达克珠单抗是两种白细胞介素-2 受体拮抗剂（IL-2RAs），可预防肾移植中的移植物衰竭，也可有效治疗类固醇难治性移植物抗宿主病（GVHD）。然而，仅有少数研究报道 IL-2RAs 可预防 GVHD。在这里，我们首次回顾性地探讨了巴利昔单抗或达克珠单抗在 82 例接受无关供体外周血造血干细胞移植（URD-PBSCT）的血液系统恶性肿瘤患者中预防 GVHD 的作用。所有受者均获得了植入。Ⅱ-Ⅳ级和Ⅲ-Ⅳ级急性移植物抗宿主病（aGVHD）的发生率分别为 35.4%和 15.9%。可评估患者中有 38.7%发生慢性移植物抗宿主病（cGVHD）。移植相关死亡率为 13.4%，复发率为 8.5%。2 年总生存率（OS）达到 77.1%，无病生存率（DFS）累积至 72.2%。巴利昔单抗和达克珠单抗的副作用为中度且可耐受。两组之间 aGVHD 的发病和生存无显著差异。然而，巴利昔单抗在预防 cGVHD 方面优于达克珠单抗。总之，巴利昔单抗或达克珠单抗可有效预防 URD-PBSCT 后的 GVHD，有助于获得良好的结局。巴利昔单抗在 aGVHD 方面具有相似的作用，但在预防 cGVHD 方面具有更好的活性。需要进一步开展前瞻性和随机对照研究。
