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Low mortality of children undergoing hematopoietic stem cell transplantation from 7 to 8/10 human leukocyte antigen allele-matched unrelated donors with the use of antithymocyte globulin

Sedláček, P. ; Formánková, R. ; Keslová, P. ; Šrámková, L. ; Hubáček, P. ; Król, L. LU orcid ; Kulich, M. and Starý, J. (2006) In Bone Marrow Transplantation 38(11). p.745-750
Abstract

Human leukocyte antigen (HLA)-matched sibling donor hematopoietic stem cell transplantation (HSCT) is available for only approximately 30% patients needing HSCT. Use of alternative donors is associated with a high incidence and severity of graft-versus-host disease (GVHD). Here we report our experience with GVHD prophylaxis using pre-transplant rabbit antithymocyte globulin (rATG), in addition to post transplant cyclosporin A and methotrexate. Seventy-five children received unmanipulated grafts from 7 to 10/10 HLA allele-matched unrelated donors. Median follow-up was 25 months (range, 6-65 months). Only 2/75 patients (2.5%) developed acute GVHD grades III-IV, and 17/75 (25%) developed extensive chronic GVHD. Overall survival was 79%. It... (More)

Human leukocyte antigen (HLA)-matched sibling donor hematopoietic stem cell transplantation (HSCT) is available for only approximately 30% patients needing HSCT. Use of alternative donors is associated with a high incidence and severity of graft-versus-host disease (GVHD). Here we report our experience with GVHD prophylaxis using pre-transplant rabbit antithymocyte globulin (rATG), in addition to post transplant cyclosporin A and methotrexate. Seventy-five children received unmanipulated grafts from 7 to 10/10 HLA allele-matched unrelated donors. Median follow-up was 25 months (range, 6-65 months). Only 2/75 patients (2.5%) developed acute GVHD grades III-IV, and 17/75 (25%) developed extensive chronic GVHD. Overall survival was 79%. It was similar in patients receiving grafts from 7 or 8/10 to 9 or 10/10 allele-matched donors, and similar in patients receiving peripheral blood stem cells and marrow. Six (11%) patients died owing to relapse, and 10 (13%) due to transplant-related complications. The addition of rATG appears to result in a low incidence of severe GVHD and overall mortality.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Bone Marrow Transplantation
volume
38
issue
11
pages
745 - 750
publisher
Nature Publishing Group
external identifiers
  • pmid:17041606
  • scopus:33751058038
ISSN
0268-3369
DOI
10.1038/sj.bmt.1705524
language
English
LU publication?
no
additional info
Funding Information: We thank our collaborators from CPH (Czech Pediatric Hematology Working Group) for referring patients, national registries of donors in Pilsen and Prague, HLA laboratories namely in Institute of Hematology and Blood Transfusion and CLIP (Childhood Leukemia Investigation Prague) in Prague. We thank Jan Storek for editorial help. This work was partly supported by Grant IGA CR NR 8223/3. Copyright: Copyright 2008 Elsevier B.V., All rights reserved.
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56e40cff-7977-41c7-af96-540d66186575
date added to LUP
2021-04-29 08:13:12
date last changed
2024-01-05 10:22:23
@article{56e40cff-7977-41c7-af96-540d66186575,
  abstract     = {{<p>Human leukocyte antigen (HLA)-matched sibling donor hematopoietic stem cell transplantation (HSCT) is available for only approximately 30% patients needing HSCT. Use of alternative donors is associated with a high incidence and severity of graft-versus-host disease (GVHD). Here we report our experience with GVHD prophylaxis using pre-transplant rabbit antithymocyte globulin (rATG), in addition to post transplant cyclosporin A and methotrexate. Seventy-five children received unmanipulated grafts from 7 to 10/10 HLA allele-matched unrelated donors. Median follow-up was 25 months (range, 6-65 months). Only 2/75 patients (2.5%) developed acute GVHD grades III-IV, and 17/75 (25%) developed extensive chronic GVHD. Overall survival was 79%. It was similar in patients receiving grafts from 7 or 8/10 to 9 or 10/10 allele-matched donors, and similar in patients receiving peripheral blood stem cells and marrow. Six (11%) patients died owing to relapse, and 10 (13%) due to transplant-related complications. The addition of rATG appears to result in a low incidence of severe GVHD and overall mortality.</p>}},
  author       = {{Sedláček, P. and Formánková, R. and Keslová, P. and Šrámková, L. and Hubáček, P. and Król, L. and Kulich, M. and Starý, J.}},
  issn         = {{0268-3369}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{745--750}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Bone Marrow Transplantation}},
  title        = {{Low mortality of children undergoing hematopoietic stem cell transplantation from 7 to 8/10 human leukocyte antigen allele-matched unrelated donors with the use of antithymocyte globulin}},
  url          = {{http://dx.doi.org/10.1038/sj.bmt.1705524}},
  doi          = {{10.1038/sj.bmt.1705524}},
  volume       = {{38}},
  year         = {{2006}},
}