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Unrelated Donor Transplants

Addition of ATG to the conditioning regimen is a major determinant for outcome after transplantation with partially lymphocyte-depleted grafts from voluntary unrelated donors

Summary:

We retrospectively analysed the outcome of voluntary unrelated donor (VUD)-SCT in 56 patients after conditioning without or with ATG. All received partially lymphocyte-depleted grafts. Four of 17 patients (24%) who were not given ATG rejected their grafts, as did one of 33 (3%) conditioned with ATG (P=0.02). The incidences of acute graft-versus-host disease grade III/IV were 29 and 6%, respectively (P=0.02), and probabilities of 1-year transplant-related mortality were 64% (95% CI, 44–84%) and 27% (95% CI, 12–42%), respectively (P=0.004). Projected at 3 years, probability of survival was 18% (95% CI, 2–34%) after conditioning without ATG and 60% (95% CI, 43–70%) after conditioning with ATG (P=0.002). Probabilities of disease-free survival (DFS) were 18% (95% CI, 2–34%) and 45% (95% CI, 27–63%), respectively (P=0.005). Patients who did not receive ATG had a probability of current DFS of 18% (95% CI, 3–34%) and this was 60% (95% CI, 43–77%) for the patients conditioned with ATG (P<0.001). We conclude that the addition of ATG to the conditioning regimen is associated with a significantly more favourable outcome in recipients of partially T-cell-depleted grafts from VUDs.

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We thank all voluntary unrelated donors.

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Correspondence to A Schattenberg.

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Schattenberg, A., Meer, A., Preijers, F. et al. Addition of ATG to the conditioning regimen is a major determinant for outcome after transplantation with partially lymphocyte-depleted grafts from voluntary unrelated donors. Bone Marrow Transplant 33, 1115–1121 (2004). https://doi.org/10.1038/sj.bmt.1704490

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