Prophylaxis of GVHD with ATG before allogeneic stem cells transplantation / 上海第二医科大学学报

ABSTRACT

Objective To analyze effects of antithymocyte globulin(ATG) in preventing the occurrence of graft-versus-host disease(GVHD) in allogeneic stem cells transplantation. Methods Twenty-seven patients with leukemia were divided into two groups.The source of the transplantation donor and the type of acute leukemia were similar between the two groups,including HLA-sibling donors,HLA-unrelated donors and HLA-haploidentical donors.The 12 patients in group A adopted the classic method(CsA + MTX) to prevent GVHD.The 15 patients in group B adopted CsA + MTX +ATG to prevent the occurrence of GVHD. Results The 15 patients in group B have been all survived.Four of them presented Ⅱ0 acute GVHD(aGVHD),while the rest 11 patients only presented Ⅰ0 GVHD in approximately 30 d after transplantation with control very soon.In group A,Ⅳ? ultra-acute GVHD occurred in 3 HLA-haploidentical patients at day 7,9 and 10 after transplantation.One HLA-unrelated patient presented Ⅲ? aGVHD.The 4 patients above mentioned died due to pulmonary infection secondary to severe GVHD.The rest 8 HLA-sibling patients presented Ⅱ?-Ⅲ? aGVHD. ConclusionUsing ATG before allogeneic stem cells transplantation can efficiently prevent the occurrence of GVHD or relieve its severity.It can significantly diminish the transplantation related mortality rate.