Abstract
Antithymocyte globulin (ATG) preparations in allogeneic stem cell transplantation are used in various conditioning regimens both to prevent graft rejection and reduce the incidence and severity of graft-versus-host disease. Tecelac (RATG) is a highly purified ATG preparation with high specific activity. The high specific antibody content implies the need for lower doses, with reduced side-effects in comparison to other ATGs. Here, we report on the first 10 patients worldwide who received RATG as part of conditioning. Patients were heterogeneous with regard to diagnoses and graft characteristics. RATG was given in cases of matched unrelated donors, mismatched family donors, reduced conditioning, or high risk for graft failure. Mostly mild allergic reactions toward RATG were seen. All of the patients engrafted in due time. Two died within 2 months of transplant of pulmonary complications not related to RATG. Two developed GVHD grade I, no chronic GVHD was seen to date. Viremia occurred in two, with no viral disease developed. Of the eight patients surviving, one suffered relapse of acute leukemia, one shows impending graft failure. The others are well. Using RATG in conditioning is feasible.
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References
Reisner Y . Graft-versus-host disease and graft rejection: competing factors in bone marrow transplantation In: Gal RP, Champlin R (eds) Progress in Bone Marrow Transplantation Alan Liss: New York 1987 53: 175 183
Bach FH, Sachs DH . Current concepts: immunology. Transplantation immunology New Engl J Med 1987 317: 489 492
Kernan NA, Flomenberg N, Dupont B, O'Reilly RJ . Graft rejection in recipients of T-cell depleted HLA-nonidentical marrow transplants for leukemia. Identification of host-derived antidonor allocytotoxic T-lymphocytes Transplantation 1987 43: 842 847
Butturini A, Seeger RC, Gale RP . Recipient immune-competent T lymphocytes can survive intensive conditioning for bone marrow transplantation Blood 1986 68: 954 956
Kröger N, Zabelina T, Krüger W et al. Anti-thymocyte-globulin as part of the preparative regimen prevents graft failure and severe graft versus host disease (GVHD) in allogeneic stem cell transplantation from unrelated donors Ann Hematol 2001 80: 209 215
Rodt H, Kolb HJ, Netzel B et al. Effect of anti-T-cell globulin on GVHD in leukemic patients treated with BMT Transplant Proc 1981 13: 257 261
Ringdén O, Remberger M, Carlens S et al. Low incidence of acute graft-versus-host disease, using unrelated HLA- A-, HLA-B-, and HLA-DR-compatible donors and conditioning, including anti-T-cell antibodies Transplantation 1998 66: 620 625
Rebellato L, Gross U, Verbanac K, Thomas J . A comprehensive definition of the major antibody specificities in polyclonal rabbit antithymocyte globulin Transplantation 1994 57: 685 694
Copeland JG, Icenogle TB, Williams RJ et al. Rabbit antithymocyte globulin J Thor Cariov Surg 1990 99: 852 860
Bertz H, Potthoff K, Mertelsmann R, Finke J . Busulfan/cyclophosphamide in volunteer unrelated donor BMT: excellent feasibility and low incidence of treatment-related toxicity Bone Marrow Transplant 1997 19: 1169 1173
Nagler A, Aker M, Or R et al. Low-intensity conditioning is sufficient to ensure engraftment in matched unrelated bone marrow transplantation Exp Hematol 2001 29: 362 370
Dubovsky J, Daxberger H, Fritsch G et al. Kinetics of chimerism during the early post-transplant period in pediatric patients with malignant and non-malignant hematologic disorders: implications for timely detection of engraftment, graft failure and rejection Leukemia 1999 13: 2060 2069
Bader P, Klingebiel T, Schaudt A et al. Prevention of relapse in pediatric patients with acute leukemias and MDS after allogeneic SCT by early immunotherapy initiated on the basis of increased mixed chimerism: a single center experience of 12 children Leukemia 1999 13: 2079 2086
Bourdage JS, Hamlin DM . Comparative polyclonal antithymocyte globulin and antilymphocyte/lymphoblast globulin anti-CD antigen analysis by flow cytometry Transplantation 1995 59: 1194 1200
Bacigalupo A, Lamparelli T, Bruzzi P et al. Antithymocyte globulin for graft-versus-host disease prophylaxis in transplants from unrelated donors: 2 randomized studies from Gruppo Italiano Trapianti Midollo Osseo (GITMO) Blood 2001 98: 2942 2947
Remberger M, Svahn BM, Hentschke P et al. Effect on cytokine release and graft-versus-host disease of different anti-T cell antibodies during conditioning for unrelated haematopoietic stem cell transplantation Bone Marrow Transplant 1999 24: 823 830
Remberger M, Mattson J, Ringdén O . Polyclonal anti-T-cell globulin as part of the preparative regimen for pediatric allogeneic stem-cell transplantation Pediatr Transplant 2001 5: 285 292
Exadaktylos P, Rumler W, Oppermann J, Gravinghoff J . [Side effects of therapy with antihuman lymphocyte globulin] Allerg Immunol (Leipz) 1984 30: 139 145
Bielory L, Gascon P, Lawley TJ et al. Human serum sickness: a prospective analysis of 35 patients treated with equine anti-thymocyte globulin for bone marrow failure Medicine (Baltimore) 1988 67: 40 57
Brophy PD, Thomas SE, McBryde KD, Bunchman TE . Comparison of polyclonal induction agents in pediatric renal transplantation Pediatr Transplant 2001 5: 174 178
Brennan DC, Flavin K, Lowell JA et al. A randomized double-blinded comparison of Thymoglobulin versus Atgam for induction immunosuppressive therapy in adult renal transplant recipients Transplantation 1999 67: 1011 1018
Bornhäuser M, Theuser C, Soucek S et al. Allogeneic transplantation of G-CSF mobilized peripheral blood stem cells from unrelated donors: a retrospective analysis Haematologica 2000 85: 839 847
Kröger N, Schetelig J, Zabelina T et al. A fludarabine-based dose-reduced conditioning regimen followed by allogeneic stem cell transplantation from related or unrelated donors in patients with myelodysplastic syndrome Bone Marrow Transplant 2001 28: 643 647
Finke J, Bertz H, Schmoor C . Allogeneic bone marrow transplantation from unrelated donors using in vivo anti-T-cell globulin Br J Haematol 2000 111: 303 313
Matsuda Y, Hara J, Osugi Y et al. Allogeneic peripheral stem cell transplantation using positively selected CD34+ cells from HLA-mismatched donors Bone Marrow Transplant 1998 21: 355 360
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Zimmermann, S., Klingebiel, T., Koehl, U. et al. Tecelac as antithymocyte globulin in conditioning for childhood allogeneic stem cell transplantation. Bone Marrow Transplant 29, 957–962 (2002). https://doi.org/10.1038/sj.bmt.1703561
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DOI: https://doi.org/10.1038/sj.bmt.1703561
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