Abstract | BACKGROUND AND OBJECTIVES: DESIGN AND METHODS: Fifteen patients received ATG as first-line treatment within 14 days of the diagnosis of GvHD (median 8 days, range 4-13). Twelve patients received ATG as second-line therapy, more than 14 days after diagnosis (median 32 days, range 14 to 98). The proportion of patients with severe (grade III-IV) GvHD at the time of ATG therapy was 4/15 in the former group and 7/13 in the latter (p=0.1). RESULTS: On day 30 after ATG the overall proportion of responders was 80% in the group administered ATG early and 38% in those given it later (p=0.03). The overall actuarial 3-year transplant-related mortality was 40% vs 74% for the early vs late ATG groups (p=0.03); the actuarial 3-year survival was, respectively, 49% vs 23% (p=0.04). For patients with GvHD grade III-IV the actuarial 1-year TRM was 47% for those given ATG early, 87% for the late ATG group and 82% for a concurrent control group of 26 patients not treated with ATG. INTERPRETATION AND CONCLUSIONS: In conclusion, ATG may be considered for early treatment of acute GvHD, within a few days from the onset of the disease. A prospective trial has been started to test whether, in this setting, low dose ATG with steroids is superior to steroids alone.
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Authors | Francesco Graziani, Maria Teresa Van Lint, Alida Dominietto, Anna Maria Raiola, Carmela Di Grazia, Teresa Lamparelli, Francesca Gualandi, Stefania Bregante, Merilù Fiorone, Barbara Bruno, Andrea Bacigalupo |
Journal | Haematologica
(Haematologica)
Vol. 87
Issue 9
Pg. 973-8
(Sep 2002)
ISSN: 0390-6078 [Print] Italy |
PMID | 12217810
(Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Antilymphocyte Serum
(administration & dosage, therapeutic use)
- Bone Marrow Transplantation
(immunology, mortality)
- Graft vs Host Disease
(drug therapy, mortality)
- Humans
- Infections
- Middle Aged
- Survival Rate
- Time Factors
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