Sun Y, Wei C, Cao C, Tan X, Zeng H, Luo Y, Chen L
Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
Transplant Proc. 2019 Apr;51(3):890-895. doi: 10.1016/j.transproceed.2018.10.028. Epub 2019 Jan 9.
Graft-vs-host disease (GVHD) is one of the biggest challenges in haploidentical hematopoietic stem cell transplantation. Antithymocyte globulins (ATGs) are widely used to overcome GVHD, but excessive immunosuppression increases the chances of relapse and infection following transplantation. No defined standard of the appropriate dose of ATG usage is recognized. The study included 11 patients who were treated with a reduced dose of ATG to prevent GVHD in haploidentical hematopoietic stem cell transplantation. A reduced dose of ATG-Thymoglobulin (total dose of 5 mg/kg) was used in the pretreatment protocol for 2 consecutive days. All patients had successful transplantation. The median time of neutrophil engraftment was 12 days. All chimerism tests passed on day 30, 60, and 90 post transplantation. None of the patients had acute GVHD, while only 2 patients had I to II degree chronic GVHD (18.2%). No transplantation-related deaths were observed. The current findings suggest that the reduced dose of ATG can effectively prevent the incidence of acute GVHD in haploidentical hematopoietic stem cell transplantation.
移植物抗宿主病（GVHD）是单倍体造血干细胞移植中最大的挑战之一。抗胸腺细胞球蛋白（ATG）被广泛用于克服GVHD，但过度免疫抑制会增加移植后复发和感染的几率。目前尚未确定ATG使用的合适剂量标准。该研究纳入了11例接受低剂量ATG治疗以预防单倍体造血干细胞移植中GVHD的患者。预处理方案连续2天使用低剂量的兔抗人胸腺细胞免疫球蛋白（总剂量为5mg/kg）。所有患者均成功移植。中性粒细胞植入的中位时间为12天。所有嵌合试验在移植后第30、60和90天均通过。所有患者均未发生急性GVHD，只有2例患者发生I至II度慢性GVHD（18.2%）。未观察到与移植相关的死亡。目前的研究结果表明，低剂量的ATG可有效预防单倍体造血干细胞移植中急性GVHD的发生。
