State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China.
State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China.
Biol Blood Marrow Transplant. 2018 Jan;24(1):86-90. doi: 10.1016/j.bbmt.2017.10.007. Epub 2017 Oct 13.
We wanted to evaluate efficacy of porcine antithymocyte globulin (ATG) in HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (MSD-HSCT) for patients with severe aplastic anemia (SAA). The clinical data of 113 SAA patients who received MSD-HSCT from January 2005 to November 2016 were analyzed retrospectively. Of these, 58 patients received rabbit ATG as a part of conditioning regimen (R-ATG group), whereas the other 55 patients received porcine ATG (P-ATG group). Patient baseline characteristics and donor conditions of the 2 groups were similar, except patients were older and more received peripheral blood stem cell transplantation in the P-ATG group. All patients engrafted in 2 groups. There were significant differences in the incidence of acute (20.7% ± 5.3% versus 43.4% ± 7.0%, P = .015) and chronic graft-versus- host disease (GVHD; 20.1% ± 5.8% versus 46.0% ± 7.9%, P = .003) between the R-ATG and P-ATG groups. However, there were no significant differences in terms of 3-year overall survival (93.1% ± 3.3% versus 84.4% ± 5.7%, P = .235), grades III to IV acute GVHD (3.4% ± 2.4% versus 12.3% ± 4.7%, P = .098), moderate to severe chronic GVHD (12.6% ± 4.9% versus 11.5% ± 4.9%, P = .905), or graft rejection (7.4% ± 3.6% versus 5.5% ± 3.1%, P = .852). There was also no significant difference with regard to the incidence of severe bacterial infection (P = .075), invasive fungal disease (P = .701), or cytomeglovirus viremia (P = .770). P-ATG showed satisfactory efficacy and safety compared with R-ATG in the setting of MSD-HSCT for SAA patients. P-ATG could be a potential alternative preparation for R-ATG, further offering the advantage of lower costs.
我们旨在评估猪抗胸腺细胞球蛋白（ATG）在 HLA 匹配的同胞供体异基因造血干细胞移植（MSD-HSCT）治疗重型再生障碍性贫血（SAA）患者中的疗效。回顾性分析了 2005 年 1 月至 2016 年 11 月期间接受 MSD-HSCT 的 113 例 SAA 患者的临床资料。其中，58 例患者接受兔抗胸腺细胞球蛋白作为预处理方案的一部分（R-ATG 组），而另外 55 例患者接受猪抗胸腺细胞球蛋白（P-ATG 组）。两组患者的基线特征和供者条件相似，但 P-ATG 组患者年龄较大，更多接受外周血造血干细胞移植。两组患者均植入。R-ATG 组和 P-ATG 组急性（20.7%±5.3%比 43.4%±7.0%，P=0.015）和慢性移植物抗宿主病（GVHD；20.1%±5.8%比 46.0%±7.9%，P=0.003）的发生率有显著差异。然而，两组间 3 年总生存率（93.1%±3.3%比 84.4%±5.7%，P=0.235）、III 级至 IV 级急性 GVHD（3.4%±2.4%比 12.3%±4.7%，P=0.098）、中重度慢性 GVHD（12.6%±4.9%比 11.5%±4.9%，P=0.905）或移植物排斥（7.4%±3.6%比 5.5%±3.1%，P=0.852）差异均无统计学意义。严重细菌感染（P=0.075）、侵袭性真菌病（P=0.701）或巨细胞病毒血症（P=0.770）的发生率也无显著差异。与 R-ATG 相比，P-ATG 在 MSD-HSCT 治疗 SAA 患者中具有令人满意的疗效和安全性。P-ATG 可能是 R-ATG 的一种潜在替代制剂，进一步具有成本更低的优势。
