International Journal of Hematology

, Volume 96, Issue 6, pp 773–780

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

  • Kazuo Hatanaka
  • Shigeo Fuji
  • Kazuhiro Ikegame
  • Ruri Kato
  • Atsushi Wake
  • Michihiro Hidaka
  • Toshiro Ito
  • Masami Inoue
  • Yoshihisa Nagatoshi
  • Akiyoshi Takami
  • Naokuni Uike
  • Hisashi Sakamaki
  • Hiromasa Yabe
  • Yasuo Morishima
  • Ritsuro Suzuki
  • Yoshiko Atsuta
  • Takahiro Fukuda
Original Article

DOI: 10.1007/s12185-012-1209-4

Cite this article as:
Hatanaka, K., Fuji, S., Ikegame, K. et al. Int J Hematol (2012) 96: 773. doi:10.1007/s12185-012-1209-4

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.

Keywords

ATG Unrelated bone marrow transplant GVHD 

Supplementary material

12185_2012_1209_MOESM1_ESM.docx (16 kb)
Supplementary Table 1 (DOCX 15 kb)

Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Kazuo Hatanaka
    • 1
    • 2
  • Shigeo Fuji
    • 3
  • Kazuhiro Ikegame
    • 4
    • 5
  • Ruri Kato
    • 4
    • 5
  • Atsushi Wake
    • 6
    • 7
  • Michihiro Hidaka
    • 8
  • Toshiro Ito
    • 9
  • Masami Inoue
    • 10
  • Yoshihisa Nagatoshi
    • 11
    • 12
  • Akiyoshi Takami
    • 13
  • Naokuni Uike
    • 14
  • Hisashi Sakamaki
    • 15
  • Hiromasa Yabe
    • 16
  • Yasuo Morishima
    • 17
  • Ritsuro Suzuki
    • 18
  • Yoshiko Atsuta
    • 18
  • Takahiro Fukuda
    • 3
  1. 1.Department of Hematology/OncologyWakayama Medical University HospitalWakayamaJapan
  2. 2.Department of Internal MedicineRinku General Medical CenterIzumisanoJapan
  3. 3.Hematopoietic Stem Cell Transplantation DivisionNational Cancer Center HospitalTokyoJapan
  4. 4.Division of Hematology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  5. 5.Department of Medicine IIIOsaka University HospitalSuitaJapan
  6. 6.Department of HematologyToranomon HospitalTokyoJapan
  7. 7.Department of HematologyToranomon Hospital KajigayaKawasakiJapan
  8. 8.Department of Internal MedicineNational Hospital Organization, Kumamoto Medical CenterKumamotoJapan
  9. 9.Division of Hematology, Department of Internal MedicineShinshu University School of MedicineNaganoJapan
  10. 10.Department of Hematology/OncologyOsaka Medical Center and Research Institute for Maternal and Child HealthIaumiJapan
  11. 11.Section of PediatricsNational Kyushu Cancer CenterFukuokaJapan
  12. 12.Department of PediatricsFukuoka National HospitalFukuokaJapan
  13. 13.Department of Hematology and OncologyKanazawa University HospitalKanzawaJapan
  14. 14.Department of HematologyNational Kyushu Cancer CenterFukuokaJapan
  15. 15.Hematology DivisionTokyo Metropolitan Cancer and Infectious Diseases Center-Komagome HospitalTokyoJapan
  16. 16.Department of Cell Transplantation and Regenerative MedicineTokai University School of MedicineTokyoJapan
  17. 17.Division of Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
  18. 18.Department of HSCT Data Management/BiostatisticsNagoya UniversityNagoyaJapan

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