The Korean journal of internal medicine

  • 제31권4호
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  • Pages.750-761
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  • 2016
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation?

  • Ji, Young Sok (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Min Sung (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Min, Chang Wook (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Park, Seong Kyu (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Se Hyung (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Yun, Jina (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Hyun Jung (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Kyoung Ha (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital) ;
  • Kim, Chan Kyu (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Kyu-Taek (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Won, Jong-Ho (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital) ;
  • Hong, Dae Sik (Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital)
  • 투고 : 2015.07.22
  • 심사 : 2015.09.13
  • 발행 : 2016.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: There is controversy about the prophylactic effect of anti-thymocyte globulin (ATG) on graft versus host disease (GVHD) in the setting of matched related-donor hematopoietic stem cell transplantation (HSCT). This study assessed the inf luences of ATG on the incidences of acute and chronic GVHD and other clinical outcomes in matched related-donor HSCT. Methods: Sixty-one patients received allogeneic HSCT from human leukocyte antigen-matched, related donors. Patients received busulfan/fludarabine conditioning regimens and standard GVHD prophylaxis with or without additional ATG. Results: There was no significant difference in the cumulative incidences of overall acute GVHD, grade II to IV acute GVHD at day 100, and chronic GVHD during the follow-up period between the ATG and non-ATG groups. Three-year overall survival rates were very similar, but three year disease-free survival of the non-ATG group was higher than that of the ATG group (56.2% for ATG vs. 63.1% for non-ATG, p = 0.597). Relapse rate at 3 years in the ATG group was slightly higher than that of the non-ATG group (37.5% vs. 20%, p = 0.29). Non-relapse mortality rate at 3 years was lower in the ATG group (6.25% vs. 15.6%, p = 0.668). Conclusions: Although the addition of ATG doesn't guarantee a reduction in the incidences of acute and chronic GVHD, pre-transplantation ATG may result in lower non-relapse mortality in the context of matched related-donor HSCT with a busulfan/fludarabine conditioning regimen. However, caution is needed when using ATG because of a possibility to increase relapse rate.

키워드

참고문헌

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피인용 문헌

  1. Impact of in vivo T cell depletion in HLA-identical allogeneic stem cell transplantation for acute myeloid leukemia in first complete remission conditioned with a fludarabine iv-busulfan myeloablative vol.10, pp.1, 2017, https://doi.org/10.1186/s13045-016-0389-4
  2. Role of thymoglobulin in matched sibling allogeneic hematopoietic stem cell transplantation with busulfan and fludarabine conditioning in myeloid malignanicies vol.53, pp.2, 2018, https://doi.org/10.1038/bmt.2017.240
  3. Application of latent class analysis in diagnosis of graft-versus-host disease by serum markers after allogeneic haematopoietic stem cell transplantation vol.10, pp.None, 2016, https://doi.org/10.1038/s41598-020-60524-2