期刊
CANCER
卷 127, 期 2, 页码 209-218出版社
WILEY
DOI: 10.1002/cncr.33255
关键词
acute myeloid leukemia; allogeneic hematopoietic transplantation; antithymocyte globulin; graft‐ versus‐ host disease; post‐ transplantation cyclophosphamide
类别
GVHD is a major complication after allo-HSCT. Adding ATG or PTCY to standard immunosuppressive agents can reduce GVHD in different donor settings. Comparing outcomes of AML patients undergoing allo-HSCT from HLA-identical sibling donors with PTCY or ATG, it was found that while the overall outcomes were similar, ATG may be associated with lower incidence of chronic GVHD.
BACKGROUND Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Addition of antithymocyte globulin (ATG) or post-transplantation cyclophosphamide (PTCY) to standard immunosuppressive agents reduces GVHD in different donor settings. METHODS We compared the outcomes of adults with acute myeloid leukemia undergoing allo-HSCT from HLA-identical sibling donors after the use of PTCY (n = 197) or ATG (n = 1913). RESULTS Patients in the PTCY group were younger than those in the ATG group (median age, 47 vs 54 years; P < .01). Peripheral blood was the most frequently used stem cell source, being significantly more frequent in the ATG group than in the PTCY group (95% vs 70% P < .01). The conditioning regimen was more frequently myeloablative in the PTCY group than in the ATG group (59% vs 48%; P < .01). Time to neutrophil engraftment was shorter in the ATG group than in the PTCY group (17 vs 20 days; P < .01). No differences were observed according to the other transplantation outcomes, except for chronic GVHD of all grades and extensive chronic GVHD at 2 years, which were significantly lower in the ATG group compared with the PTCY group (P < .02). CONCLUSION PTCY is feasible in an HLA-identical sibling setting, and despite similar outcomes, ATG may be associated with lower incidence of chronic GVHD.
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