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Effects of ATG

Assessment of the coagulation profile in hemato-oncological patients receiving ATG-based conditioning treatment for allogeneic stem cell transplantation

Bone Marrow Transplantation volume 34, pages 459–463 (2004)Cite this article

Summary:

Antithymocyte globulin (ATG) is increasingly used in pre-allogeneic stem cell transplantation (allo-SCT) conditioning regimens to prevent graft rejection and graft-versus-host disease. However, ATG was also found to be associated with increased incidence of thrombosis during organ transplantation. In the present study, we tested the coagulation status of 21 patients with hematologic malignancies undergoing allo-SCT who received ATG-based (11 patients) or non-ATG-based (10) conditioning treatment. We assessed several thrombophilia markers as well as circulating total and endothelial microparticles (TMP/EMP) and soluble CD40 ligand (CD40L). No significant difference in the mean values of prothrombin time, partial thromboplastin time, fibrinogen, antithrombin, protein C, protein S, thrombin–antithrombin III complex, homocysteine levels, prevalence of genetic thrombophilia markers and levels of EMP, TMP or CD40L was observed between the ATG-treated and ATG-untreated patients, as well as before and after conditioning in each group separately. Platelet counts decreased significantly in ATG-treated patients; however, this decrease was not associated with clinical or laboratory evidence of disseminated intravascular coagulation. No patient developed thromboembolic event or veno-occlusive liver disease. Our results suggest that allo-SCT is not associated with increased hypercoagulability and addition of ATG to conditioning regimen has no significant procoagulant effect.

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Acknowledgements

This work is supported in part by a research grant from Fresenius (AN, AI, Gmbh Munich, Germany). The sponsor had no role in design, collection, analysis or interpretation of data as well on the decision to submit this paper for publication.

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Author notes

  1. I Levi

    Present address: Institute of Hematology, Soroka Medical Center, Beer Sheva, Israel

  2. A Inbal and A Lubetsky: First authors.

Authors and Affiliations

  1. Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel

    A Inbal, A Lubetsky, R Dardik & R Eskaraev

  2. Department of Bone Marrow Transplantation, Sheba Medical Center, Tel Hashomer, Israel

    A Shimoni, I Levi, N S Tov & A Nagler

  3. Institute of Chemical Pathology, Sheba Medical Center, Tel Hashomer, Israel

    B-A Sela

  4. Sackler Faculty of Medicine, Tel Aviv University, Israel

    A Inbal, A Lubetsky, A Shimoni, R Dardik, B-A Sela, R Eskaraev, I Levi, N S Tov & A Nagler

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Inbal, A., Lubetsky, A., Shimoni, A. et al. Assessment of the coagulation profile in hemato-oncological patients receiving ATG-based conditioning treatment for allogeneic stem cell transplantation. Bone Marrow Transplant 34, 459–463 (2004). https://doi.org/10.1038/sj.bmt.1704609

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