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Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors

We compared the efficacy and safety of porcine anti-lymphocyte globulin (pALG) (n=140) and rabbit anti-thymocyte globulin (rATG) (n=86) in patients with acquired aplastic anemia (AA) receiving hematopoietic stem cell transplantation (HSCT) from matched sibling donors (MSD) in two transplantation cen...

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Autores principales: Zhang, Yuanfeng, Chen, Xin, Li, Lin, Li, Yun, Lin, Li, Cao, Yang, Wang, Na, Yang, Donglin, Pang, Aiming, Zhang, Rongli, Ma, Qiaoling, Zhai, Weihua, He, Yi, Wei, Jialin, Jiang, Erlie, Han, MingZhe, Zhang, Yicheng, Feng, Sizhou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9241985/
https://www.ncbi.nlm.nih.gov/pubmed/35784311
http://dx.doi.org/10.3389/fimmu.2022.889784
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author Zhang, Yuanfeng
Chen, Xin
Li, Lin
Li, Yun
Lin, Li
Cao, Yang
Wang, Na
Yang, Donglin
Pang, Aiming
Zhang, Rongli
Ma, Qiaoling
Zhai, Weihua
He, Yi
Wei, Jialin
Jiang, Erlie
Han, MingZhe
Zhang, Yicheng
Feng, Sizhou
author_facet Zhang, Yuanfeng
Chen, Xin
Li, Lin
Li, Yun
Lin, Li
Cao, Yang
Wang, Na
Yang, Donglin
Pang, Aiming
Zhang, Rongli
Ma, Qiaoling
Zhai, Weihua
He, Yi
Wei, Jialin
Jiang, Erlie
Han, MingZhe
Zhang, Yicheng
Feng, Sizhou
author_sort Zhang, Yuanfeng
collection PubMed
description We compared the efficacy and safety of porcine anti-lymphocyte globulin (pALG) (n=140) and rabbit anti-thymocyte globulin (rATG) (n=86) in patients with acquired aplastic anemia (AA) receiving hematopoietic stem cell transplantation (HSCT) from matched sibling donors (MSD) in two transplantation centers in China ranging from 2005 to 2020. The groups had similar baseline characteristics except for a higher number of infused mononuclear cells (P<0.001) and a higher proportion of peripheral blood stem cells as graft sources (P=0.003) in the pALG group. The rates of neutrophil engraftment at day 28 (P=1), platelet engraftment at day 28 (P=0.228), bloodstream infection before engraftment (P=0.867), invasive fungal diseases (P=0.362), cytomegalovirus viremia (P=0.667), and graft rejection (P=0.147) were similar in the two groups. A higher cumulative incidence of grades II-IV acute graft versus host disease (aGvHD) at 100 days occurred in the pALG group (19% vs. 8%, P=0.035) while no significant differences in grades III-IV aGvHD (P=0.572), mild to severe chronic GvHD (cGvHD) (P=0.181), and moderate to severe cGvHD (P=0.586) were observed. The actuarial 5-year overall survival (OS), failure-free survival (FFS), and GvHD-free, FFS rates of the pALG group were 87% (95% confidence interval [CI], 82-93), 85% (95% CI, 80-92), and 78% (95% CI, 72-92) versus 91% (95% CI, 86-99) (P=0.33), 88% (95% CI, 82-97) (P=0.428), and 79% (95% CI, 72-90) (P=0.824) in the rATG group, respectively. A busulfan-containing conditioning regimen was the only adverse risk factor for OS and FFS in multivariate analysis. In conclusion, pALG is an alternative to rATG in patients with severe AA receiving MSD-HSCT. A prospective, large-sample study is needed to explore this therapy further.
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spelling pubmed-92419852022-06-30 Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors Zhang, Yuanfeng Chen, Xin Li, Lin Li, Yun Lin, Li Cao, Yang Wang, Na Yang, Donglin Pang, Aiming Zhang, Rongli Ma, Qiaoling Zhai, Weihua He, Yi Wei, Jialin Jiang, Erlie Han, MingZhe Zhang, Yicheng Feng, Sizhou Front Immunol Immunology We compared the efficacy and safety of porcine anti-lymphocyte globulin (pALG) (n=140) and rabbit anti-thymocyte globulin (rATG) (n=86) in patients with acquired aplastic anemia (AA) receiving hematopoietic stem cell transplantation (HSCT) from matched sibling donors (MSD) in two transplantation centers in China ranging from 2005 to 2020. The groups had similar baseline characteristics except for a higher number of infused mononuclear cells (P<0.001) and a higher proportion of peripheral blood stem cells as graft sources (P=0.003) in the pALG group. The rates of neutrophil engraftment at day 28 (P=1), platelet engraftment at day 28 (P=0.228), bloodstream infection before engraftment (P=0.867), invasive fungal diseases (P=0.362), cytomegalovirus viremia (P=0.667), and graft rejection (P=0.147) were similar in the two groups. A higher cumulative incidence of grades II-IV acute graft versus host disease (aGvHD) at 100 days occurred in the pALG group (19% vs. 8%, P=0.035) while no significant differences in grades III-IV aGvHD (P=0.572), mild to severe chronic GvHD (cGvHD) (P=0.181), and moderate to severe cGvHD (P=0.586) were observed. The actuarial 5-year overall survival (OS), failure-free survival (FFS), and GvHD-free, FFS rates of the pALG group were 87% (95% confidence interval [CI], 82-93), 85% (95% CI, 80-92), and 78% (95% CI, 72-92) versus 91% (95% CI, 86-99) (P=0.33), 88% (95% CI, 82-97) (P=0.428), and 79% (95% CI, 72-90) (P=0.824) in the rATG group, respectively. A busulfan-containing conditioning regimen was the only adverse risk factor for OS and FFS in multivariate analysis. In conclusion, pALG is an alternative to rATG in patients with severe AA receiving MSD-HSCT. A prospective, large-sample study is needed to explore this therapy further. Frontiers Media S.A. 2022-06-01 /pmc/articles/PMC9241985/ /pubmed/35784311 http://dx.doi.org/10.3389/fimmu.2022.889784 Text en Copyright © 2022 Zhang, Chen, Li, Li, Lin, Cao, Wang, Yang, Pang, Zhang, Ma, Zhai, He, Wei, Jiang, Han, Zhang and Feng https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Zhang, Yuanfeng
Chen, Xin
Li, Lin
Li, Yun
Lin, Li
Cao, Yang
Wang, Na
Yang, Donglin
Pang, Aiming
Zhang, Rongli
Ma, Qiaoling
Zhai, Weihua
He, Yi
Wei, Jialin
Jiang, Erlie
Han, MingZhe
Zhang, Yicheng
Feng, Sizhou
Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title_full Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title_fullStr Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title_full_unstemmed Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title_short Retrospective Comparison of Efficacy and Safety of Rabbit Anti-Thymocyte Globulin and Porcine Anti-Lymphocyte Globulin in Patients With Acquired Aplastic Anemia Undergoing Hematopoietic Stem Cell Transplantation From Matched Sibling Donors
title_sort retrospective comparison of efficacy and safety of rabbit anti-thymocyte globulin and porcine anti-lymphocyte globulin in patients with acquired aplastic anemia undergoing hematopoietic stem cell transplantation from matched sibling donors
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9241985/
https://www.ncbi.nlm.nih.gov/pubmed/35784311
http://dx.doi.org/10.3389/fimmu.2022.889784
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