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Addition of a Single Low Dose of Anti T-Lymphocyte Globulin to Post-Transplant Cyclophosphamide after Allogeneic Hematopoietic Stem Cell Transplant: A Pilot Study.
Xue, Elisabetta; Lorentino, Francesca; Lupo Stanghellini, Maria Teresa; Giglio, Fabio; Piemontese, Simona; Clerici, Daniela Teresa; Farina, Francesca; Mastaglio, Sara; Bruno, Alessandro; Campodonico, Edoardo; Nitti, Rosamaria; Marcatti, Magda; Assanelli, Andrea; Corti, Consuelo; Ciceri, Fabio; Peccatori, Jacopo; Greco, Raffaella.
  • Xue E; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Lorentino F; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Lupo Stanghellini MT; PhD Program in Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy.
  • Giglio F; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Piemontese S; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Clerici DT; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Farina F; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Mastaglio S; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Bruno A; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Campodonico E; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Nitti R; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Marcatti M; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Assanelli A; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Corti C; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Ciceri F; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Peccatori J; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
  • Greco R; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
J Clin Med ; 11(4)2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-1715434
ABSTRACT
Correlation between risk of graft-versus-host disease (GvHD) and CD3+ counts within the peripheral blood stem cell graft has recently been reported in the setting of post-transplant cyclophosphamide (PT-Cy). We aimed to investigate the benefit of the addition of a single dose of anti-T lymphocyte globulin (ATLG 5 mg/kg) to PT-Cy in this setting. Starting in 2019, all patients receiving PBSC transplant containing CD3+ counts above 300 × 106/kg (study group) received a post-transplant dose of ATLG in addition to standard PT-Cy. The study was designed as a real-life analysis and included all consecutive Hematopoietic Stem Cell Transplantation (HSCT) recipients according to the above-mentioned inclusion criterion (n = 21), excluding cord blood and bone marrow donors. Using a 12 matched-pair analysis, we compared the outcomes with a historical population who received PT-Cy only (control group). We found a delayed platelet engraftment (29% vs. 45% at 30 days, p = 0.03) and a non-significant trend toward higher risk of poor graft function (29% vs. 19%, p = 0.52). The addition of ATLG impacted long-term immune reconstitution on the CD4+ subsets, but this did not translate into higher rate of relapse or viral infection. Acute GvHD was not significantly impacted, but 1-year cumulative incidence of chronic GvHD was significantly lower in the study group (15% vs. 41%, p = 0.04). Survival outcomes were comparable. In conclusion PT-Cy and ATLG was overall safe and translated into a low rate of chronic GvHD incidence.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11041106

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11041106