Anti-Thymocyte Globulin Prior To Transplantation May Improve Prognosis Of MDS Patients (ASCO 2012)
Published: Jun 20, 2012 9:37 am
French researchers have found that adding anti-thymocyte globulin to the preparative treatment for stem cell transplantation may improve outcomes for myelodysplastic syndromes patients.
Specifically, patients treated with anti-thymocyte globulin (ATG) during preparative treatment experienced significantly fewer cases of acute graft-versus-host disease, a common transplant-related complication in which donor immune cells recognize the recipient’s cells as foreign and attack them.
These results were presented earlier this month at the American Society of Clinical Oncology’s annual meeting in Chicago.
Stem cell transplantation is currently the only potential cure for myelodysplastic syndromes (MDS). The procedure involves high-dose chemotherapy that kills the patient’s stem cells, which are then replaced by healthy stem cells from a healthy donor.
ATG is an antibody that suppresses the immune system, preventing transplant rejection.
According to the French researchers, the addition of ATG to the preparative treatment for stem cell transplantation is still controversial because it is unclear whether the immune system suppression caused by ATG affects the risk of disease relapse.
In order to assess the effect of ATG on stem cell transplantation outcomes, the French researchers analyzed data from 242 MDS patients who received a stem cell transplant between 1999 and 2009.
The median patient age at the time of transplant was 52 years. All patients included in the analysis had progressive disease at the time of the transplant.
Forty-five percent of patients received myeloablative chemotherapy, in preparation for their transplant, in which all of their bone marrow stem cells were destroyed. The remaining 55 percent received non-myeloablative chemotherapy, in which a lower dosage of the chemotherapy is used and some of the patient’s bone marrow stem cells remain.
Approximately two-thirds (68 percent) of the patients received ATG as part of their preparative treatment.
The researchers did not find any significant differences in the three-year relapse, event-free survival, and overall survival rates between patients who received ATG as part of their preparative treatment and those who did not.
However, significantly fewer patients who received ATG experienced acute graft-versus-host disease, which develops within 100 days of transplantation, than patients who did not (27 percent versus 56 percent, respectively).
The rates of chronic graft-versus-host disease, which occurs after the first 100 days post transplant, were similar between both treatment groups.
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