title: ATG as part of the conditioning regimen reduces transplant-related mortality (TRM) and improves overall survival after unrelated stem cell transplantation in patients with chronic myelogenous leukemia (CML).
abstract: Matched unrelated donor transplants have an increased risk of severe graft-versus-host disease and transplant-related mortality (TRM). ATG has been introduced to decrease GvHD and to facilitate engraftment. We conducted a retrospective analysis of 333 patients with chronic myelogenous leukemia, who were treated with Fresenius ATG (n=145, average=90 mg/kg bw, range 40-90 mg/kg bw) or standard immunosuppression without ATG (n=188). Both groups were comparable regarding distribution of age, sex, HLA-matched vs mismatched donors. ATG Fresenius led to a faster leukocyte engraftment, decreased the incidence of acute GvHD and TRM (P=0.01 and P=0.03) and led to a significant better overall survival (70 vs 57%, P=0.03). We concluded that a prospective randomized study is needed to evaluate the definite role of ATG in hemopoietic stem cell transplantation.
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Germany.
authors.forename: A R
authors.initials: AR
authors.lastname: Zander
authors.forename: N
authors.initials: N
authors.lastname: Kröger
authors.forename: M
authors.initials: M
authors.lastname: Schleuning
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.forename: T
authors.initials: T
authors.lastname: Zabelina
authors.forename: D
authors.initials: D
authors.lastname: Beelen
authors.forename: R
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: H
authors.initials: H
authors.lastname: Baurmann
authors.forename: M
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: G
authors.initials: G
authors.lastname: Ehninger
authors.forename: A A
authors.initials: AA
authors.lastname: Fauser
authors.forename: M
authors.initials: M
authors.lastname: Kiehl
authors.forename: R
authors.initials: R
authors.lastname: Trenschel
authors.forename: H D
authors.initials: HD
authors.lastname: Ottinger
authors.forename: H
authors.initials: H
authors.lastname: Bertz
authors.forename: J
authors.initials: J
authors.lastname: Berger
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kolb
authors.forename: U W
authors.initials: UW
authors.lastname: Schaefer
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000494:pharmacology*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents