Modi Dipenkumar, Kim Seongho, Surapaneni Malini, Ayash Lois, Ratanatharathorn Voravit, Uberti Joseph P, Deol Abhinav
Department of Oncology, Blood and Marrow Stem Cell Transplant Program, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA.
Biostatistics Core, Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, USA.
Leuk Lymphoma. 2020 Dec;61(13):3137-3145. doi: 10.1080/10428194.2020.1805114. Epub 2020 Aug 11.
Anti-thymocyte globulin (ATG) targets in-vivo T lymphocytes. Variations in the recipient absolute lymphocyte count (ALC) might result in a variable exposure of ATG. We hypothesized that recipient ALC on the first day of ATG might predict transplant outcomes. We evaluated 217 patients undergoing 8/8 HLA-matched unrelated donor (MUD) peripheral blood stem cell transplant (PBSCT) between January 2005 and December 2017, and receiving rabbit ATG (Thymoglobulin, total dose 4.5 mg/kg) on days -3, -2 and -1. With a median follow up of 3.68 years for survival (OS), one-year OS, relapse rate, non-relapse mortality (NRM), and relapse-free survival (RFS) were 64.7%, 15.9%, 25.8%, and 58.4%, respectively. Multivariable analysis revealed that ALC > 100 k/mm was associated with superior RFS (HR 0.64, = .03). Our study indicates that ALC on the first day of thymoglobulin affects relapse-free survival in MUD PBSCT when weight-based thymoglobulin is used.
抗胸腺细胞球蛋白（ATG）作用于体内的T淋巴细胞。受者绝对淋巴细胞计数（ALC）的变化可能导致ATG的暴露量不同。我们推测，ATG治疗第一天时的受者ALC可能预测移植结局。我们评估了2005年1月至2017年12月期间接受8/8 HLA匹配的无关供者（MUD）外周血干细胞移植（PBSCT）并在第-3、-2和-1天接受兔ATG（即胸腺球蛋白，总剂量4.5mg/kg）的217例患者。中位总生存（OS）随访时间为3.68年，1年OS、复发率、非复发死亡率（NRM）和无复发生存率（RFS）分别为64.7%、15.9%、25.8%和58.4%。多变量分析显示，ALC>100k/mm与更好的RFS相关（风险比0.64，P = 0.03）。我们的研究表明，当使用基于体重的胸腺球蛋白时，胸腺球蛋白治疗第一天的ALC会影响MUD PBSCT的无复发生存率。
