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- Title
Addition of a Single Low Dose of Anti T-Lymphocyte Globulin to Post-Transplant Cyclophosphamide after Allogeneic Hematopoietic Stem Cell Transplant: A Pilot Study.
- Authors
Xue, Elisabetta; Lorentino, Francesca; Lupo Stanghellini, Maria Teresa; Giglio, Fabio; Piemontese, Simona; Clerici, Daniela Teresa; Farina, Francesca; Mastaglio, Sara; Bruno, Alessandro; Campodonico, Edoardo; Nitti, Rosamaria; Marcatti, Magda; Assanelli, Andrea; Corti, Consuelo; Ciceri, Fabio; Peccatori, Jacopo; Greco, Raffaella
- Abstract
Correlation between risk of graft-versus-host disease (GvHD) and CD3+ counts within the peripheral blood stem cell graft has recently been reported in the setting of post-transplant cyclophosphamide (PT-Cy). We aimed to investigate the benefit of the addition of a single dose of anti-T lymphocyte globulin (ATLG 5 mg/kg) to PT-Cy in this setting. Starting in 2019, all patients receiving PBSC transplant containing CD3+ counts above 300 × 106/kg (study group) received a post-transplant dose of ATLG in addition to standard PT-Cy. The study was designed as a real-life analysis and included all consecutive Hematopoietic Stem Cell Transplantation (HSCT) recipients according to the above-mentioned inclusion criterion (n = 21), excluding cord blood and bone marrow donors. Using a 1:2 matched-pair analysis, we compared the outcomes with a historical population who received PT-Cy only (control group). We found a delayed platelet engraftment (29% vs. 45% at 30 days, p = 0.03) and a non-significant trend toward higher risk of poor graft function (29% vs. 19%, p = 0.52). The addition of ATLG impacted long-term immune reconstitution on the CD4+ subsets, but this did not translate into higher rate of relapse or viral infection. Acute GvHD was not significantly impacted, but 1-year cumulative incidence of chronic GvHD was significantly lower in the study group (15% vs. 41%, p = 0.04). Survival outcomes were comparable. In conclusion PT-Cy and ATLG was overall safe and translated into a low rate of chronic GvHD incidence.
- Subjects
STEM cell transplantation; HEMATOPOIETIC stem cells; HEMATOPOIETIC stem cell transplantation; GLOBULINS; CORD blood
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 4, pN.PAG
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11041106