International Journal of Hematology

, Volume 98, Issue 5, pp 608–614

Reduced-intensity conditioning regimen with low-dose ATG-F for unrelated bone marrow transplant is associated with lower non-relapse mortality than a regimen with low-dose TBI: a single-center retrospective analysis of 103 cases

  • Shigeo Fuji
  • Niina Ueno
  • Nobuhiro Hiramoto
  • Yoshitaka Asakura
  • Kimikazu Yakushijin
  • Yutaro Kamiyama
  • Saiko Kurosawa
  • Sung-Won Kim
  • Yuji Heike
  • Takuya Yamashita
  • Takahiro Fukuda
Original Article

DOI: 10.1007/s12185-013-1449-y

Cite this article as:
Fuji, S., Ueno, N., Hiramoto, N. et al. Int J Hematol (2013) 98: 608. doi:10.1007/s12185-013-1449-y

Abstract

Although anti-T lymphocyte globulin-Fresenius (ATG-F) is commonly used as prophylaxis for graft-versus-host disease (GVHD), the appropriate dosage of ATG-F in the setting of a reduced-intensity conditioning (RIC) regimen has not been determined. In the present study, we retrospectively analyzed the clinical outcomes of 103 patients after unrelated bone marrow transplant (uBMT) with RIC regimens. RIC regimens consisted of purine analogue plus busulfan with low-dose TBI or ATG-F (5–10 mg/kg in total). Median age was 57 years (range 20–68). The incidence of grade II–IV acute GVHD and chronic GVHD with ATG-F was significantly lower than that with TBI 2 Gy (15 vs. 61 %, P < 0.05; 33 vs. 57 %, P < 0.05). The incidence of 2-year NRM with ATG-F was significantly lower than that with TBI 2 Gy (6 vs. 28 %, P < 0.05). There was no statistically significant difference in the cumulative incidence of 2-year relapse between the ATG-F and TBI 2 Gy groups (37 vs. 20 %, P = 0.13). In conclusion, the addition of low-dose ATG-F to GVHD prophylaxis in patients who received uBMT resulted in decreased incidence of acute and chronic GVHD, which led to a significantly reduced risk of NRM without compromising overall survival. The beneficial effect of low-dose ATG-F should be assessed in a prospective clinical trial.

Keywords

ATGUnrelated bone marrow transplantGVHD

Copyright information

© The Japanese Society of Hematology 2013

Authors and Affiliations

  • Shigeo Fuji
    • 1
  • Niina Ueno
    • 1
  • Nobuhiro Hiramoto
    • 1
  • Yoshitaka Asakura
    • 1
  • Kimikazu Yakushijin
    • 1
  • Yutaro Kamiyama
    • 1
  • Saiko Kurosawa
    • 1
  • Sung-Won Kim
    • 1
  • Yuji Heike
    • 1
  • Takuya Yamashita
    • 1
  • Takahiro Fukuda
    • 1
  1. 1.Hematopoietic Stem Cell Transplantation DivisionNational Cancer Center HospitalTokyoJapan