The impact of antithymocyte globulin on short-term toxicity after allogeneic stem cell transplantation
| Autor: | M Pihusch, Mühlbayer D, Kolb Hj, Erhard Hiller, Stötzer O, R. Pihusch, Peter Göhring, Ernst Holler |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Adolescent medicine.medical_treatment Prednisolone Gastroenterology Internal medicine medicine Humans Transplantation Homologous Antilymphocyte Serum Retrospective Studies Disseminated intravascular coagulation Inflammation Transplantation Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Hemodynamics Hematology Disseminated Intravascular Coagulation Middle Aged medicine.disease Haematopoiesis Endocrinology Hematologic Neoplasms Toxicity Chemoprophylaxis Drug Evaluation Female Kidney Diseases business Complication Immunosuppressive Agents medicine.drug |
| Zdroj: | Bone marrow transplantation. 30(6) |
| ISSN: | 0268-3369 |
| Popis: | Antithymocyte globulin (ATG) is commonly used in allogeneic haematopoietic stem cell transplantation (HSCT). Little information is available, however, as to the optimal protocol for use and the side-effects occurring if ATG is administered in high daily doses (10-30 mg/kg). We report our experience with ATG Fresenius (ATG-F) in conditioning for allogeneic HSCT. During a period of 3 days, 47 patients received doses between 10 and 30 mg/kg either over 4 h preceded by 1-1.5 mg/kg prednisolone 30 min before the start of ATG-F (protocol A) or alternatively, over 12 h with 3-4 mg/kg prednisolone being administered before and 6 h after start of ATG (protocol B). During treatment with ATG-F, the side-effects observed included inflammation, disseminated intravascular coagulation, hyperdynamic circulation and renal dysfunction. Although these complications caused substantial morbidity, they were reversible within a few days. Side-effects were significantly more severe in patients treated according to protocol A than in those treated according to protocol B. As prolonged infusion of ATG-F does not reduce T cell clearance due to the long half-life of ATG-F, and since less cytokine release during conditioning might have beneficial long-term effects, we recommend administering ATG-F over 12 h preceded by high-dose steroid treatment. |
| Databáze: | OpenAIRE |
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