Antithymocyte globulin administration in patients with profound lymphopenia receiving a PBSC purine analog/busulfan-based conditioning regimen allograft.

Abstract

Graft-versus host disease (GVHD) remains one of the main causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (ASCT). Prophylactic T cell depletion via antithymocyte globulin (ATG) during ASCT conditioning is one of the standards of care for GVHD prophylaxis, although the optimal dosing strategy is still unclear. Recent studies have reported that absolute lymphocyte count at the time of ATG administration could predict survivals in ASCT from unrelated donors. Here this issue was examined in 116 patients receiving peripheral blood stem cells (PBSC) ASCT with purine analog/busulfan-based conditioning regimens between 2009 and 2019 in our department. The impact of lymphopenia at the time of ATG administration was evaluated in terms of overall survival, disease-free survival and GVHD-free/relapse-free survival. After a median follow-up of 4 years, no adverse effect of a profound lymphopenia was observed on patients' outcome. Notably, a reduced dose of ATG in patients with profound lymphopenia did not translate into better survivals. This study indicates that ATG can be administered whatever the recipient's lymphocyte counts in patients receiving a PBSC purine analog/busulfan-based conditioning regimen ASCT.

• Authors: Maxime Jullien, Thierry Guillaume, Pierre Peterlin, Alice Garnier, Amandine Le Bourgeois, Camille Debord, Beatrice Mahe, Viviane Dubruille, Soraya Wuilleme, Nicolas Blin, Cyrille Touzeau, Thomas Gastinne, Benoit Tessoulin, Yannick Le Bris, Marion Eveillard, Alix Duquesne, Philippe Moreau, Steven Le Gouill, Marie C Bene, Patrice Chevallier
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 15399 (09 21 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 32958816 (Publication Type: Journal Article)

Chemical References

• Antilymphocyte Serum
• Purine Nucleosides
• Busulfan

Topics

• Adult
• Aged
• Allografts
• Antilymphocyte Serum (administration & dosage, metabolism, therapeutic use)
• Busulfan (administration & dosage)
• Disease-Free Survival
• Female
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (mortality)
• Humans
• Lymphocyte Depletion
• Lymphopenia (drug therapy, etiology)
• Male
• Middle Aged
• Peripheral Blood Stem Cell Transplantation (methods)
• Peripheral Blood Stem Cells (drug effects)
• Purine Nucleosides (administration & dosage)
• Retrospective Studies
• Transplantation Conditioning
• Transplantation, Homologous