John Joseph M, Kulkarni Uday, Pendharkar Dinesh, Jadhav Sachin
Department of Clinical Haematology, Haemato-Oncology & Bone Marrow (Stem Cell) Transplantation, Christian Medical College, Ludhiana, India.
Department of Haematology, Christian Medical College, Vellore, India.
J Cell Mol Med. 2025 Jun;29(11):e70450. doi: 10.1111/jcmm.70450.
Allogeneic haematopoietic stem cell transplantation (HSCT) for haematological malignancies can cause acute and chronic graft-versus-host disease (GvHD), impacting graft success and mortality. Rabbit anti-thymocyte globulin (r-ATG) or post-transplant cyclophosphamide (PTCy) is effective in reducing GvHD in haploidentical-HSCT. This review included 17 studies to assess rATG + PTCy for GvHD prophylaxis. Overall acute GvHD grade II-IV, moderate-to-severe chronic GvHD and GvHD-free relapse-free survival rates ranged from 11.50%-35.40%, 2.90%-17.78% and 21.80%-63%, respectively. Although r-ATG + PTCy treatment lowered GvHD incidence and increased survival rates, cytomegalovirus and Epstein-Barr virus reactivation were observed; therefore, more investigations on this treatment are needed, especially on dosing and timing when used for HSCT.
用于血液系统恶性肿瘤的异基因造血干细胞移植（HSCT）可引发急性和慢性移植物抗宿主病（GvHD），影响移植成功率和死亡率。兔抗胸腺细胞球蛋白（r-ATG）或移植后环磷酰胺（PTCy）在降低单倍体相合HSCT中的GvHD方面有效。本综述纳入了17项研究，以评估rATG + PTCy预防GvHD的效果。总体而言，急性GvHD II-IV级、中重度慢性GvHD以及无GvHD且无复发生存率分别为11.50%-35.40%、2.90%-17.78%和21.80%-63%。尽管r-ATG + PTCy治疗降低了GvHD发生率并提高了生存率，但观察到巨细胞病毒和EB病毒再激活；因此，需要对这种治疗进行更多研究，尤其是用于HSCT时的给药剂量和时机。
