The response-guided ATG treatment provides a survival benefit and KPS recovery for patients with steroid refractory acute GVHD: The Nagasaki Transplant Group Experience
| Autor: | Takeharu Kato, Shinya Sato, Tomoko Hata, Yasushi Sawayama, Yasushi Miyazaki, Hikaru Sakamoto, Hideaki Kitanosono, Hidehiro Itonaga, Yukiyoshi Moriuchi, Yoshitaka Imaizumi, Sachie Kasai, Machiko Fujioka, Takafumi Furumoto, Makiko Horai, Shinichiro Yoshida, Jun Taguchi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Poor prognosis Adolescent medicine.medical_treatment Immunology Drug Resistance Graft vs Host Disease Disease Hematopoietic stem cell transplantation 030230 surgery Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life immune system diseases Internal medicine medicine Humans Transplantation Homologous Immunology and Allergy Karnofsky Performance Status Antilymphocyte Serum Transplantation business.industry Hematopoietic Stem Cell Transplantation Middle Aged Survival Analysis surgical procedures operative Survival benefit Acute Disease Chronic gvhd Female Steroids Complication Steroid refractory business Immunosuppressive Agents 030215 immunology |
| Zdroj: | Transplant Immunology. 67:101417 |
| ISSN: | 0966-3274 |
| DOI: | 10.1016/j.trim.2021.101417 |
| Popis: | Steroid-refractory acute graft-versus-host disease (SR-aGVHD) is a serious complication that negatively affects the prognosis and quality of life of patients who receive allogeneic hematopoietic stem cell transplantation (allo-HSCT). Antithymocyte globulin (ATG) is one of the second-line treatments for SR-aGVHD. We retrospectively evaluated Karnofsky Performance Status (KPS) recovery and clinical response in 11 patients who received the response-guided low-dose ATG treatment for SR-aGVHD after allo-HSCT using alternative donors. The median dose of ATG per cycle was 1.0 mg/kg (range, 1.0–1.25 mg/kg) and the median number of cycles of ATG was 2 (range, 1–4). The overall response rate was 63.6%, and the estimated overall survival rate at 1 year was 63.6%. Two out of seven patients who survived 1 year after the response-guided ATG treatment had KPS of 80 or higher. The remaining 5 patients had KPS of lower than 80 due to moderate chronic GVHD (cGVHD) and/or ≥grade 3 infectious complications. Based on the poor prognosis of patients with SR-aGVHD, the response-guided ATG treatment represents one therapeutic option. The present results also suggest that chronic GVHD and infectious complications after the response-guided ATG treatment were associated with decreased KPS recovery and impaired social function. |
| Databáze: | OpenAIRE |
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