猪抗人T淋巴细胞免疫球蛋白与兔ATG预防GVHD的比较

IF 3.2 4区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Current Research in Translational Medicine Pub Date : 2025-01-01 DOI:10.1016/j.retram.2025.103501

Shiyuan Zhou , Chao Ma , Danping Zhou , Qian Zhu , Wenjuan Zhu , Jing Li , Depei Wu , Xiao Ma , Xiaojin Wu

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引用次数: 0

摘要

除兔抗胸腺细胞球蛋白（r-ATG）外，抗淋巴细胞球蛋白在hla匹配的兄弟姐妹造血干细胞移植（MSD-HSCT）后预防移植物抗宿主病（GVHD）中的研究有限。本研究的目的是探讨猪抗人T淋巴细胞免疫球蛋白（p-ATG）和r-ATG对血液恶性肿瘤患者MSD-HSCT结果的不同影响。患者和方法本回顾性分析纳入了373例连续患者，这些患者于2019年1月至2023年10月期间接受了MSD-HSCT。135例患者接受r-ATG （5mg/kg）治疗，51例接受p-ATG （30mg/kg）治疗预防GVHD。187例未接受r-ATG或p-ATG治疗。结果除早期死亡外，未发生移植失败。与其他组相比，r-ATG组中性粒细胞着床时间提前，血小板着床时间延迟。r-ATG和p-ATG组对慢性移植物抗宿主病（cGVHD）均有保护作用（移植后2年分别为13.9%和29.6%，对照组为43.0%），而只有r-ATG组显示急性移植物抗宿主病（aGVHD）发生率降低（移植后100天为24.9%，对照组为39.8%）。r-ATG组和p-ATG组的无gvhd和无复发生存率（GRFS）在HSCT后2年分别为63.4%和56.8%，对照组为37.0%。多因素分析发现R-ATG是aGVHD、cGVHD和GRFS的独立保护因素。结论本研究进一步证实了ATG在MSD-HSCT中改善预后的作用。在研究中，没有证据支持用p-ATG代替r-ATG达到这些效果。

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A comparison of porcine anti-human T lymphocyte immunoglobulin, rabbit-ATG for GVHD prophylaxis and without ATG in matched sibling donor transplantation

Introduction

Research on anti-lymphocyte globulins other than rabbit anti-thymocyte globulin (r-ATG) in prevention of graft-versus-host-disease (GVHD) following HLA-matched siblings hematopoietic stem cell transplantation (MSD-HSCT) is limited. The objective of this study is to investigate the distinct impacts of porcine anti-human T lymphocyte immunoglobulin (p-ATG) and r-ATG on outcomes of MSD-HSCT in patients with hematologic malignancies.

Patients and methods

This retrospective analysis enrolled 373 consecutive patients who underwent MSD-HSCT from January 2019 to October 2023. 135 patients received r-ATG (5mg/kg) and 51 received p-ATG (30mg/kg) for GVHD prophylaxis. 187 did not receive r-ATG or p-ATG.

Results

Despite early deaths, no engraftment failure occurred. In the r-ATG group, neutrophil engraftment was observed earlier, while platelet engraftment was delayed compared to other groups. Both r-ATG and p-ATG group showed protective effect on chronic graft-versus-host disease (cGVHD) (13.9 % and 29.6 % respectively vs. 43.0 % of control group at 2 years post HSCT), whereas only the r-ATG group displayed a decreased acute GVHD (aGVHD) rate (24.9 % vs. 39.8 % of control group at day 100 post HSCT). GVHD-free and relapse-free survival (GRFS) were found superior in both r-ATG and p-ATG groups (63.4 % and 56.8 % respectively vs. 37.0 % of control group at 2 years post HSCT). R-ATG was identified as an independent protective factor for aGVHD, cGVHD and GRFS in multivariate analysis.

Conclusions

Our study further confirmed the role of ATG in MSD-HSCT for improving the outcomes. No evidence supported substituting r-ATG with p-ATG in achieving these effects in the study.

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来源期刊

Current Research in Translational Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology

CiteScore

7.00

自引率

4.90%

发文量

审稿时长

45 days

期刊介绍： Current Research in Translational Medicine is a peer-reviewed journal, publishing worldwide clinical and basic research in the field of hematology, immunology, infectiology, hematopoietic cell transplantation, and cellular and gene therapy. The journal considers for publication English-language editorials, original articles, reviews, and short reports including case-reports. Contributions are intended to draw attention to experimental medicine and translational research. Current Research in Translational Medicine periodically publishes thematic issues and is indexed in all major international databases (2017 Impact Factor is 1.9). Core areas covered in Current Research in Translational Medicine are: Hematology, Immunology, Infectiology, Hematopoietic, Cell Transplantation, Cellular and Gene Therapy.