Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies
Haploidentical hematopoietic stem cell transplantation using post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis has emerged as a valid alternative transplant strategy for patients lacking a suitable HLA-matched related donor. The high risk of severe GVHD remains...
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MDPI AG
2022-11-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/15/11/1423 |
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| author | Kang-Hsi Wu Te-Fu Weng Ju-Pi Li Yu-Hua Chao |
| author_facet | Kang-Hsi Wu Te-Fu Weng Ju-Pi Li Yu-Hua Chao |
| author_sort | Kang-Hsi Wu |
| collection | DOAJ |
| description | Haploidentical hematopoietic stem cell transplantation using post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis has emerged as a valid alternative transplant strategy for patients lacking a suitable HLA-matched related donor. The high risk of severe GVHD remains the major clinical challenge in this setting. The addition of antithymocyte globulin (ATG) in PTCy-based regimens for GVHD reduction in haploidentical hematopoietic stem cell transplantation is rational and was reported in adult series. However, its feasibility is unknown in pediatric patients. Here, we firstly describe our experience of 15 consecutive children with high-risk malignancies receiving haploidentical peripheral blood stem cell transplantation using ATG plus PTCy for GVHD prophylaxis. Only three patients developed grade 1–2 acute GVHD, limited to skin. No grade 3–4 acute GVHD and chronic GVHD were observed. Viral reactivations were frequently seen but manageable. Six patients relapsed, as the main cause of death in our series. None died from events related to GVHD. Our data suggest that ATG plus PTCy is an effective strategy for GVHD prevention in haploidentical peripheral blood stem cell transplantation and is feasible in children with high-risk malignancies. |
| first_indexed | 2024-03-09T18:04:38Z |
| format | Article |
| id | doaj.art-50718cfef1f84acea7f2334912f189f0 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-09T18:04:38Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-50718cfef1f84acea7f2334912f189f02023-11-24T09:35:31ZengMDPI AGPharmaceuticals1424-82472022-11-011511142310.3390/ph15111423Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk MalignanciesKang-Hsi Wu0Te-Fu Weng1Ju-Pi Li2Yu-Hua Chao3Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, TaiwanDepartment of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, TaiwanDepartment of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, TaiwanDepartment of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, TaiwanHaploidentical hematopoietic stem cell transplantation using post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis has emerged as a valid alternative transplant strategy for patients lacking a suitable HLA-matched related donor. The high risk of severe GVHD remains the major clinical challenge in this setting. The addition of antithymocyte globulin (ATG) in PTCy-based regimens for GVHD reduction in haploidentical hematopoietic stem cell transplantation is rational and was reported in adult series. However, its feasibility is unknown in pediatric patients. Here, we firstly describe our experience of 15 consecutive children with high-risk malignancies receiving haploidentical peripheral blood stem cell transplantation using ATG plus PTCy for GVHD prophylaxis. Only three patients developed grade 1–2 acute GVHD, limited to skin. No grade 3–4 acute GVHD and chronic GVHD were observed. Viral reactivations were frequently seen but manageable. Six patients relapsed, as the main cause of death in our series. None died from events related to GVHD. Our data suggest that ATG plus PTCy is an effective strategy for GVHD prevention in haploidentical peripheral blood stem cell transplantation and is feasible in children with high-risk malignancies.https://www.mdpi.com/1424-8247/15/11/1423antithymocyte globulinchildrengraft-versus-host diseasehaploidentical transplantationpost-transplant cyclophosphamide |
| spellingShingle | Kang-Hsi Wu Te-Fu Weng Ju-Pi Li Yu-Hua Chao Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies Pharmaceuticals antithymocyte globulin children graft-versus-host disease haploidentical transplantation post-transplant cyclophosphamide |
| title | Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies |
| title_full | Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies |
| title_fullStr | Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies |
| title_full_unstemmed | Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies |
| title_short | Antithymocyte Globulin Plus Post-Transplant Cyclophosphamide Combination as an Effective Strategy for Graft-versus-Host Disease Prevention in Haploidentical Peripheral Blood Stem Cell Transplantation for Children with High-Risk Malignancies |
| title_sort | antithymocyte globulin plus post transplant cyclophosphamide combination as an effective strategy for graft versus host disease prevention in haploidentical peripheral blood stem cell transplantation for children with high risk malignancies |
| topic | antithymocyte globulin children graft-versus-host disease haploidentical transplantation post-transplant cyclophosphamide |
| url | https://www.mdpi.com/1424-8247/15/11/1423 |
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