Effect of Antithymocyte Globulin Source on Outcomes of HLA-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia

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Abstract

We wanted to evaluate efficacy of porcine antithymocyte globulin (ATG) in HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (MSD-HSCT) for patients with severe aplastic anemia (SAA). The clinical data of 113 SAA patients who received MSD-HSCT from January 2005 to November 2016 were analyzed retrospectively. Of these, 58 patients received rabbit ATG as a part of conditioning regimen (R-ATG group), whereas the other 55 patients received porcine ATG (P-ATG group). Patient baseline characteristics and donor conditions of the 2 groups were similar, except patients were older and more received peripheral blood stem cell transplantation in the P-ATG group. All patients engrafted in 2 groups. There were significant differences in the incidence of acute (20.7% ± 5.3% versus 43.4% ± 7.0%, P =.015) and chronic graft-versus- host disease (GVHD; 20.1% ± 5.8% versus 46.0% ± 7.9%, P =.003) between the R-ATG and P-ATG groups. However, there were no significant differences in terms of 3-year overall survival (93.1% ± 3.3% versus 84.4% ± 5.7%, P =.235), grades III to IV acute GVHD (3.4% ± 2.4% versus 12.3% ± 4.7%, P =.098), moderate to severe chronic GVHD (12.6% ± 4.9% versus 11.5% ± 4.9%, P =.905), or graft rejection (7.4% ± 3.6% versus 5.5% ± 3.1%, P =.852). There was also no significant difference with regard to the incidence of severe bacterial infection (P =.075), invasive fungal disease (P =.701), or cytomeglovirus viremia (P =.770). P-ATG showed satisfactory efficacy and safety compared with R-ATG in the setting of MSD-HSCT for SAA patients. P-ATG could be a potential alternative preparation for R-ATG, further offering the advantage of lower costs.

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APA

Chen, X., Wei, J., Huang, Y., He, Y., Yang, D., Zhang, R., … Han, M. (2018). Effect of Antithymocyte Globulin Source on Outcomes of HLA-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia. Biology of Blood and Marrow Transplantation, 24(1), 86–90. https://doi.org/10.1016/j.bbmt.2017.10.007

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