Abstract:
This retrospective analysis evaluated the use of anti-thymocyte globulin (ATG) with or without post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GvHD) prophylaxis in children with acute leukemia undergoing hematopoietic stem cell transplantation (HSCT). The study included 57 children, with 35 in the ATG-PTCy group and 22 in the ATG group. While overall incidence of acute and chronic GvHD did not differ significantly between groups, the ATG-PTCy group had lower rates of grade II-IV acute GvHD (p = 0.013) and moderate-to-severe chronic GvHD (p = 0.001) compared to the ATG group. Importantly, ATG-PTCy significantly improved GvHD/relapse-free survival (GRFS) compared to ATG (65.71% vs. 36.63%; p = 0.003). There were no differences in engraftment, infection rates, immune reconstitution, overall survival, leukemia-free survival, relapse rate, or non-relapse mortality between the two groups. Combining ATG with PTCy may reduce moderate-to-severe GvHD and improve GRFS in children undergoing HSCT for acute leukemia.
摘要:
这项回顾性分析评估了在接受造血干细胞移植(HSCT)的急性白血病儿童中,使用或不使用移植后环磷酰胺(PTCy)预防移植物抗宿主病(GvHD)的抗胸腺细胞球蛋白(ATG)。这项研究包括57名儿童,ATG-PTCy组35例,ATG组22例。虽然急性和慢性GvHD的总发病率在组间没有显著差异,与ATG组相比,ATG-PTCy组的II-IV级急性GvHD(p=0.013)和中重度慢性GvHD(p=0.001)发生率较低.重要的是,与ATG相比,ATG-PTCy显着改善了GvHD/无复发生存率(GRFS)(65.71%vs.36.63%;p=0.003)。雕刻没有差异,感染率,免疫重建,总生存率,无白血病生存,复发率,或两组之间的非复发死亡率。在接受HSCT治疗急性白血病的儿童中,ATG与PTCy联合可能会减少中重度GvHD并改善GRFS。