Effectiveness of in vivo T‐cell‐depleted regimen containing porcine anti‐lymphocyte globulin or rabbit anti‐thymocyte globulin in preventing acute graft‐versus‐host disease after haploidentical haematopoietic stem cell transplantation

Author:

Xu Ziwei1,Zhou Xi2,Zhao Xiaoyan1,Lu Xuan1,Wang Huafang1ORCID

Affiliation:

1. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China

2. Institute of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China

Abstract

SummaryTo compare the clinical efficacy of porcine anti‐lymphocyte globulin (p‐ALG) and rabbit anti‐thymocyte globulin (r‐ATG) in the treatment of haematological malignancies using haploidentical haematopoietic stem cell transplantation (haplo‐HSCT), this study was conducted. The incidences of neutrophil and platelet engraftment, respectively, were 100%, 93.6% and 94.4%; 100%, 93.6% and 90.3% in p‐ALG 75 mg/kg (n = 57), p‐ALG 90 mg/kg (n = 49), and r‐ATG 7.5 mg/kg (n = 72). The median time to neutrophil engraftment and platelet engraftment were 11, 12 and 12 days (p = 0.032); 13, 14 and 13 days (p = 0.013), respectively. The incidence of grades II–IV acute graft‐versus‐host disease and cumulative incidence of chronic graft‐versus‐host disease were 16.7% versus 12.5% versus 13.3% (p = 0.817) and 14.7% versus 12.1% versus 19.5% in p‐ALG 75 mg/kg, p‐ALG 90 mg/kg and r‐ATG groups. Notably, the cytomegalovirus infection rate in the p‐ALG 75 mg/kg group was significantly lower than the other two groups. The cumulative incidence of 2‐year relapse and 2‐year overall survival rates were similar (p = 0.901, p = 0.497). The lower dose of p‐ALG (75 mg/kg) had a similar efficacy and safety profile compared with r‐ATG (7.5 mg/kg) in the setting of haplo‐HSCT. Therefore, p‐ALG (75 mg/kg) may be an appropriate alternative to r‐ATG in the conditioning regimen of haplo‐HSCT.

Publisher

Wiley

Subject

Hematology

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