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Outcomes of conditioning with rabbit antithymocyte globulin and rituximab in haploidentical haematopoietic stem cell transplantation in patients with severe aplastic anaemia

Bone Marrow Transplantation volume 55, pages 1854–1856 (2020)Cite this article

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The risk of rejection, graft failure (GF) and refractory graft-versus-host disease (GVHD) in acquired severe aplastic anaemia (SAA) is high when using haploidentical donors [1]. A number of clinical studies have demonstrated that T-cell depletion using antithymocyte globulin (ATG) reduces the incidence of both acute and chronic GVHD (cGVHD) in HLA-matched or -mismatched donor allografting [2]. Rituximab has been introduced during the conditioning regimen in very few trials for B-cell lymphoma, and the results indicated that rituximab reduced the incidence of GVHD [3]. To the best of our knowledge, there is no report about the outcomes of conditioning with rabbit ATG (rATG) and rituximab in haploidentical haematopoietic stem cell transplantation (haplo-HSCT) for patients with SAA. Therefore, evaluating the effect of rituximab in combination with rATG for haplo-HSCT in patients with SAA is in high demand. In the present study, we investigated the effect of a single dose of rituximab (375 mg/m2) in combination with rATG in the haplo-HSCT conditioning regimen of SAA in our centres. All patients and donors provided written informed consent for the protocol. This study was approved by our hospital’s Ethics Committee.

All 16 patients with SAA who underwent haplo-HSCT at our centres between September 2010 and September 2018 were enrolled in this study. Details of conditioning regimen, graft collection and infusion, GVHD prophylaxis and treatment strategy, supportive care and post-transplantation surveillance and other supportive care are consistent with our previous experience [4]. Rituximab (375 mg/m2/day) was intravenously used on day −1.

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Fig. 1: Patient overall survival (OS) and GVHD-free, failure-free survival (GFFS) as assessed using Kaplan−Meier analysis.

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Acknowledgements

This work was partly supported by grants from National Key R&D Program of China (2016YFC0902800, 2017YFA0104502, 2017ZX09304021), Innovation Capability Development Project of Jiangsu Province (BM2015004), Jiangsu Provincial Key Medical Center (YXZXA2016002), Jiangsu Medical Outstanding Talents Project (JCRCA2016002) and Priority Academic Program Development of Jiangsu Higher Education Institutions.

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  1. These authors contributed equally: Limin Liu, Yanming Zhang, Shan Liu

Authors and Affiliations

  1. The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, 188 Shizi Street, Suzhou, 215006, Jiangsu, China

    Limin Liu, Huifen Zhou, Qingyuan Wang, Huiying Qiu, Xiaowen Tang, Yue Han, Chengcheng Fu, Zhengming Jin, Suning Chen, Aining Sun, Miao Miao & Depei Wu

  2. Department of Hematology, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an, No 62, Huaihai Road (S.), Huai’an, China

    Yanming Zhang

  3. Department of Laboratory Medicine, Affiliated Hospital of University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China

    Shan Liu

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  1. Limin Liu
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Correspondence to Miao Miao or Depei Wu.

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Liu, L., Zhang, Y., Liu, S. et al. Outcomes of conditioning with rabbit antithymocyte globulin and rituximab in haploidentical haematopoietic stem cell transplantation in patients with severe aplastic anaemia. Bone Marrow Transplant 55, 1854–1856 (2020). https://doi.org/10.1038/s41409-020-0788-6

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