兔抗人胸腺细胞免疫球蛋白用于血液病患者第二次异基因造血干细胞移植的安全性

OBJECTIVE: To look into the security of a second allogeneic hematopoietic stem cell transplantation（allo-HSCT）using rabbit anti-human thymocyte immunoglobulin（rATG）. METHODS: Twenty-seven patients who used rATG in the first and second allo-HSCT at the Institute of Hematology, Peking University were enrolled in the study. Experienced toxicities associated with the conditioning protocol within 10 days（−5 d to +3 d）following the beginning of the rATG application, including fever, diarrhea, arrhythmia, reduced blood pressure, liver damage, seizures, and other problems. RESULTS: The overall incidence of conditioning regimen early adverse reactions during the first transplantation and the second allo-HSCT conditioning regimen was 96.3％ and 77.8％（P＝0.043）. Fever rates were 81.5％ and 63.0％（P＝0.129）, diarrhea rates were 59.3％ and 25.9％（P＝0.013）, liver damage rates were 22.2％ and 25.9％（P＝0.75）, and the rates of other events（cardiac arrhythmia, low blood pressure, and epilepsy）were 3.7％ and 18.5％（P＝0.083）. Adverse reactions that occurred during both the first and second course of rATG applications have been improved with symptomatic treatment, and no treatment interruptions occurred. CONCLUSION: Reusing rATG in a second transplant was risk-free and did not result in higher early toxicities.