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Low incidences of acute and chronic graft-versus-host disease after unrelated bone marrow transplantation with low-dose anti-T lymphocyte globulin

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An Erratum to this article was published on 25 December 2012

Abstract

Anti-T lymphocyte globulin (ATG) is commonly used as prophylaxis for graft-versus-host disease (GVHD), especially in patients who are at high risk of GVHD. The appropriate dosage of ATG in Japan has not yet been assessed. We therefore conducted a nationwide survey of patients who received ATG-Fresenius as GVHD prophylaxis for unrelated bone marrow transplantation (uBMT). A total of 86 patients were identified (median age 31 years, range 1–68). The median total dose of ATG was 10 mg/kg. The cumulative incidence of neutrophil engraftment was 90 %. The probability of 2-year overall survival (OS) was 67 %. The cumulative incidence of 2-year non-relapse mortality was 25 %. The incidences of grade II–IV and grade III–IV acute GVHD were 20 and 8 %, respectively. The incidences of chronic and extensive chronic GVHD were 19 and 8 %, respectively. In adult patients, there was a reduction of acute GVHD with high-dose ATG (>10 mg/kg), which did not reach statistical significance. In conclusion, the addition of low-dose ATG to GVHD prophylaxis in Japanese patients who received uBMT resulted in decreased incidences of both acute and chronic GVHD without compromising OS. The effects of low-dose ATG should be assessed in a prospective clinical trial.

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Acknowledgments

We thank the medical, nursing, data-processing, laboratory, and clinical staff at the participating centers for their important contributions to this study and their dedicated care of the patients. This work was supported by grants from the Japanese Ministry of Health, Labour and Welfare and the National Cancer Research and Development Fund (23-A-28).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Hematology/Oncology, Wakayama Medical University Hospital, Wakayama, Japan

    Kazuo Hatanaka

  2. Department of Internal Medicine, Rinku General Medical Center, Izumisano, Japan

    Kazuo Hatanaka

  3. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan

    Shigeo Fuji & Takahiro Fukuda

  4. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Kazuhiro Ikegame & Ruri Kato

  5. Department of Medicine III, Osaka University Hospital, Suita, Japan

    Kazuhiro Ikegame & Ruri Kato

  6. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Atsushi Wake

  7. Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan

    Atsushi Wake

  8. Department of Internal Medicine, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan

    Michihiro Hidaka

  9. Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Nagano, Japan

    Toshiro Ito

  10. Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Iaumi, Japan

    Masami Inoue

  11. Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan

    Yoshihisa Nagatoshi

  12. Department of Pediatrics, Fukuoka National Hospital, Fukuoka, Japan

    Yoshihisa Nagatoshi

  13. Department of Hematology and Oncology, Kanazawa University Hospital, Kanzawa, Japan

    Akiyoshi Takami

  14. Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan

    Naokuni Uike

  15. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center-Komagome Hospital, Tokyo, Japan

    Hisashi Sakamaki

  16. Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Tokyo, Japan

    Hiromasa Yabe

  17. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Yasuo Morishima

  18. Department of HSCT Data Management/Biostatistics, Nagoya University, Nagoya, Japan

    Ritsuro Suzuki & Yoshiko Atsuta

Authors
  1. Kazuo Hatanaka
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  2. Shigeo Fuji
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  3. Kazuhiro Ikegame
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  4. Ruri Kato
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  5. Atsushi Wake
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  6. Michihiro Hidaka
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  7. Toshiro Ito
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  8. Masami Inoue
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  9. Yoshihisa Nagatoshi
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  11. Naokuni Uike
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  13. Hiromasa Yabe
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  14. Yasuo Morishima
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  15. Ritsuro Suzuki
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  16. Yoshiko Atsuta
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  17. Takahiro Fukuda
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Corresponding author

Correspondence to Takahiro Fukuda.

Additional information

K. Hatanaka and S. Fuji contributed equally to this work.

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Hatanaka, K., Fuji, S., Ikegame, K. et al. Low incidences of acute and chronic graft-versus-host disease after unrelated bone marrow transplantation with low-dose anti-T lymphocyte globulin. Int J Hematol 96, 773–780 (2012). https://doi.org/10.1007/s12185-012-1209-4

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  • DOI: https://doi.org/10.1007/s12185-012-1209-4

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