Treatment of acute graft versus host disease with low dose-alternate day anti-thymocyte globulin.

Abstract:

BACKGROUND AND OBJECTIVES:The efficacy of antithymocyte globulin (ATG) in the treatment of graft-versus-host disease (GvHD) is controversial. In the present study we report on the use of low dose ATG (thymoglobuline, Sangstat) and steroids in 28 patients with moderate to severe acute GvHD. DESIGN AND METHODS:Fifteen patients received ATG as first-line treatment within 14 days of the diagnosis of GvHD (median 8 days, range 4-13). Twelve patients received ATG as second-line therapy, more than 14 days after diagnosis (median 32 days, range 14 to 98). The proportion of patients with severe (grade III-IV) GvHD at the time of ATG therapy was 4/15 in the former group and 7/13 in the latter (p=0.1). RESULTS:On day 30 after ATG the overall proportion of responders was 80% in the group administered ATG early and 38% in those given it later (p=0.03). The overall actuarial 3-year transplant-related mortality was 40% vs 74% for the early vs late ATG groups (p=0.03); the actuarial 3-year survival was, respectively, 49% vs 23% (p=0.04). For patients with GvHD grade III-IV the actuarial 1-year TRM was 47% for those given ATG early, 87% for the late ATG group and 82% for a concurrent control group of 26 patients not treated with ATG. INTERPRETATION AND CONCLUSIONS:In conclusion, ATG may be considered for early treatment of acute GvHD, within a few days from the onset of the disease. A prospective trial has been started to test whether, in this setting, low dose ATG with steroids is superior to steroids alone.

journal_name

Haematologica

journal_title

Haematologica

authors

Graziani F,Van Lint MT,Dominietto A,Raiola AM,Di Grazia C,Lamparelli T,Gualandi F,Bregante S,Fiorone M,Bruno B,Bacigalupo A

keywords:

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

973-8

issue

9

eissn

0390-6078

issn

1592-8721

journal_volume

87

pub_type

临床试验,杂志文章,随机对照试验
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    doi:

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    doi:

    authors: Centurioni R,Leoni P,Russo D,Brianzoni MF,Montillo M,Baccarani M,Tura S

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  • Granulocyte colony-stimulating factor after autologous CD34+ immunoselected peripheral blood stem cell transplantation.

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    pub_type: 临床试验,信件,随机对照试验

    doi:

    authors: Piccirillo N,De Matteis S,Sorà F,d'Onofrio G,Leone G,Sica S

    更新日期:2004-09-01 00:00:00

  • Structural and cellular mechanisms of peptidyl-prolyl isomerase Pin1-mediated enhancement of Tissue Factor gene expression, protein half-life, and pro-coagulant activity.

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    pub_type: 杂志文章

    doi:10.3324/haematol.2017.183087

    authors: Kurakula K,Koenis DS,Herzik MA Jr,Liu Y,Craft JW Jr,van Loenen PB,Vos M,Tran MK,Versteeg HH,Goumans MTH,Ruf W,de Vries CJM,Şen M

    更新日期:2018-06-01 00:00:00

  • The interleukin-3 receptor CD123 targeted SL-401 mediates potent cytotoxic activity against CD34+CD123+ cells from acute myeloid leukemia/myelodysplastic syndrome patients and healthy donors.

    abstract::Diseases with clonal hematopoiesis such as myelodysplastic syndrome and acute myeloid leukemia have high rates of relapse. Only a small subset of acute myeloid leukemia patients are cured with chemotherapy alone. Relapse in these diseases occurs at least in part due to the failure to eradicate leukemic stem cells or h...

    journal_title:Haematologica

    pub_type: 杂志文章

    doi:10.3324/haematol.2018.188193

    authors: Mani R,Goswami S,Gopalakrishnan B,Ramaswamy R,Wasmuth R,Tran M,Mo X,Gordon A,Bucci D,Lucas DM,Mims A,Brooks C,Dorrance A,Walker A,Blum W,Byrd JC,Lozanski G,Vasu S,Muthusamy N

    更新日期:2018-08-01 00:00:00