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Anti-Thymocyte Globulin

Dose-dependent effects of in vivo antithymocyte globulin during conditioning for allogeneic bone marrow transplantation from unrelated donors in patients with chronic phase CML

Bone Marrow Transplantation volume 32, pages 243–250 (2003)Cite this article

Summary:

We conducted a dose–escalation study with antithymocyte globulin (ATG) in patients undergoing unrelated donor bone marrow transplantation (URD-BMT). This study analyzes the results for 97 patients with chronic myelogenous leukemia (CML) in first chronic phase. Median age was 36 years (16–51). In all, 40 patients were transplanted within 2 years after diagnosis and 57 later during disease. ATG-S (Fresenius) 20–120 mg/kg body weight (b.w.) was given prior to transplantation. A total of 31 patients received less than 60 mg/kg b.w. and 66 patients received 60 mg/kg b.w. or more. All patients except one were grafted with bone marrow, and graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and methotrexate. Graft failure did occur in one patient. Grade II–IV acute GVHD developed in 56.7% and extensive chronic GVHD in 11.3% of the patients. The relapse rate was 13.4%. With a median follow-up of 5.8 years (1.5–12.1), 5-year disease-free and overall survival for all patients were 56 and 66%, and for patients transplanted within 2 years of diagnosis it was 72 and 82%. A lower dose of ATG was a significant risk factor for poor outcome. In summary, URD-BMT remains an excellent treatment option for patients with early phase CML, if a sufficient amount of ATG is included in the preparative regimen.

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Authors and Affiliations

  1. Medical Clinic III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany

    M Schleuning, J Tischer, G Ledderose & H-J Kolb

  2. Clinical Cooperative Group Hematopoietic Cell Transplantation, GSF-National Research Center for Environment and Health, Munich, Germany

    W Günther & H-J Kolb

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  1. M Schleuning
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  2. W Günther
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  3. J Tischer
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  4. G Ledderose
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  5. H-J Kolb
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Schleuning, M., Günther, W., Tischer, J. et al. Dose-dependent effects of in vivo antithymocyte globulin during conditioning for allogeneic bone marrow transplantation from unrelated donors in patients with chronic phase CML. Bone Marrow Transplant 32, 243–250 (2003). https://doi.org/10.1038/sj.bmt.1704135

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