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Anti-thymocyte globulin

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https://www.readbyqxmd.com/read/28062916/low-dose-anti-thymocyte-globulin-reduce-severe-acute-and-chronic-graft-versus-host-disease-after-allogeneic-stem-cell-transplantation
#1
Osamu Imataki, Kensuke Matsumoto, Makiko Uemura
BACKGROUND: Anti-thymocyte globulin (ATG) administered at 5-10 mg/kg can prevent graft-versus-host disease (GVHD). We sought to investigate the potential for lower doses of ATG to decrease non-relapse mortality (NRM). METHODS: We consecutively compared the outcomes of patients with hematological diseases who received allogeneic stem cell transplants from allogeneic related or unrelated donors before February 2010 and were not administered ATG (reference arm), with those administered 2...
January 6, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28013483/spousal-hematopoietic-stem-cell-transplantation
#2
Kazuhiro Ikegame, Katsuji Kaida, Satoshi Yoshihara, Kyoko Yoshihara, Shinichi Ishii, Takayuki Inoue, Masaya Okada, Hiroya Tamaki, Toshihiro Soma, Yasushi Kusunoki, Hiroto Kojima, Hiroh Saji, Hiroyasu Ogawa
We report a pilot series of five patients who received stem cell transplantation (SCT) from a spouse for post-transplant relapse or rejection. The inclusion criterion regarding HLA disparities was three or fewer antigen mismatches in the graft-versus-host direction at the HLA-A, B, and DR loci. Four patients received spousal SCT as a third transplant attempt after post-transplant relapse and one as rescue for graft rejection. The reduced intensity conditioning (RIC) regimen consisted of fludarabine, melphalan, and anti-thymocyte globulin (ATG) with 3 Gy of total body irradiation (TBI) for relapse cases and ATG plus 4 Gy of TBI for the rejection case...
December 24, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/28013015/alternative-donor-transplantation-with-high-dose-post-transplantation-cyclophosphamide-for-refractory-severe-aplastic-anemia
#3
Amy E DeZern, Marianna Zahurak, Heather Symons, Kenneth Cooke, Richard J Jones, Robert A Brodsky
Severe aplastic anemia (SAA) is a life-threatening hematopoietic stem cell disorder that is treated with bone marrow transplantation (BMT) or immunosuppressive therapy (IST). The management of patients with refractory SAA after IST is a major challenge. Alternative donor BMT is best chance for cure in refractory SAA, but morbidity and mortality from graft failure and complications of graft-versus-host disease (GVHD) have limited enthusiasm for this approach. Here, we employed post-transplantation high-dose cyclophosphamide in an effort to safely expand the donor pool in 16 consecutive patients with refractory SAA who did not have a matched sibling donor...
December 21, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27943503/invasive-fungal-infection-after-heart-transplantation-a-seven-year-single-center-experience
#4
Ignacio A Echenique, Michael P Angarone, Robert A Gordon, Jonathan Rich, Allen S Anderson, Edwin C McGee, Travis O Abicht, Joseph Kang, Valentina Stosor
BACKGROUND: Invasive fungal infections (IFIs) are an infrequent but major complication of heart-transplantation (HT). We sought to describe the epidemiology at our institution. METHODS: A prospective cohort study of 159 HT recipients was performed from June 2005 to December 2012. IFIs were defined by European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. RESULTS: By univariate analysis, Hispanic ethnicity/race was associated with IFI (P=0...
December 10, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27938472/post-transplant-immune-activation-innocent-bystander-or-insidious-culprit-of-post-transplant-accelerated-atherosclerosis
#5
Didier Ducloux, Jamal Bamoulid, Thomas Crepin, Jean-Michel Rebibou, Cecile Courivaud, Philippe Saas
Cardiovascular disease is a major cause of morbidity, disability, and mortality in kidney transplant patients. Cumulative reports indicate that the excessive risk of cardiovascular events is not entirely explained by the increased prevalence of traditional cardiovascular risk factors. Atherosclerosis is a chronic inflammatory disease and it has been postulated that post-transplant immune disturbances may explain the gap between the predicted and observed risks of cardiovascular events. However, whereas concordant data suggest that innate immunity contributes to the posttransplant accelerated atherosclerosis, only few arguments plead for a role of adaptive immunity...
27, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27927772/anti-thymocyte-globulin-as-graft-versus-host-disease-prevention-in-the-setting-of-allogeneic-peripheral-blood-stem-cell-transplantation-a-review-from-the-acute-leukemia-working-party-of-the-european-society-for-blood-and-marrow-transplantation
#6
Frédéric Baron, Mohamad Mohty, Didier Blaise, Gérard Socié, Myriam Labopin, Jordi Esteve, Fabio Ciceri, Sebastian Giebel, Norbert Claude Gorin, Bipin N Savani, Christoph Schmid, Arnon Nagler
Allogeneic hematopoietic stem cell transplantation is increasingly used as treatment for patients with life threatening blood diseases. Their curative potential is largely based on immune-mediated graft-versus-leukemia effects caused by donor T cells contained in the graft. Unfortunately, donor T cells are also the cause of graft-versus-host disease. The vast majority of HLA-matched allogeneic hematopoietic stem cell transplantations are nowadays carried out with peripheral blood stem cells (PBSC) as stem cell source...
December 7, 2016: Haematologica
https://www.readbyqxmd.com/read/27905258/hla-mismatched-haploidentical-transplantation-using-low-dose-anti-thymocyte-globulin-atg-thymoglobulin
#7
Shinichi Kako, Yu Akahoshi, Naonori Harada, Hirofumi Nakano, Kazuaki Kameda, Tomotaka Ugai, Ryoko Yamasaki, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Miki Sato, Masahiro Ashizawa, Kiriko Terasako-Saito, Shun-Ichi Kimura, Misato Kikuchi, Hideki Nakasone, Rie Yamazaki, Junya Kanda, Yoshinobu Kanda
Objectives To clarify optimal strategies for human leukocyte antigen (HLA)-mismatched haploidentical hematopoietic stem cell transplantation (HSCT). Methods Twelve patients who underwent HSCT from a haploidentical related donor using low-dose thymoglobulin were analyzed retrospectively. Thymoglobulin was added to conditioning regimens at 2.5 mg/kg/day for 2 days (days -4 and -3). Prophylaxis against graft-versus-host disease (GVHD) was performed with cyclosporine and methotrexate. Results The median age of the patients was 33 years...
December 1, 2016: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27899357/a-phase-iii-randomized-trial-comparing-inolimomab-vs-usual-care-in-steroid-resistant-acute-gvhd
#8
Gérard Socié, Stéphane Vigouroux, Ibrahim Yakoub-Agha, Jacques-Olivier Bay, Sabine Fürst, Karin Bilger, Felipe Suarez, Mauricette Michallet, Dominique Bron, Philippe Gard, Zakaria Medeghri, Philippe Lehert, Chinglin Lai, Tim Corn, Jean-Paul Vernant
Treatment of steroid resistant (SR) aGVHD remains an unmet clinical need. Inolimomab, a monoclonal antibody to CD25, has shown encouraging results in phase II trials. This phase III randomized, open-label, multicenter compared Inolimomab vs. usual care in adult patients with steroid-refractory aGvHD. Patients were randomized to treatment with Inolimomab or usual care [control group were all treated with Anti Thymocyte Globulin (ATG)]. The primary objective was to evaluate overall survival at 1 year without changing baseline allocated therapy...
November 29, 2016: Blood
https://www.readbyqxmd.com/read/27798202/anti-thymocyte-globulins-in-kidney-transplantation-focus-on-current-indications-and-long-term-immunological-side-effects
#9
REVIEW
Jamal Bamoulid, Oliver Staeck, Thomas Crépin, Fabian Halleck, Philippe Saas, Susanne Brakemeier, Didier Ducloux, Klemens Budde
Antithymocyte globulins (ATGs) are part of the immunosuppression arsenal currently used by clinicians to prevent or treat acute rejection in solid organ transplantation. ATG is a mixture of non-specific anti-lymphocyte immunoglobulins targeting not only T cell subsets but also several other immune and non-immune cells, rendering its precise immunoglobulin composition difficult to appreciate or to compare from one preparation to another. Furthermore, several mechanisms of action have been described. Taken together, this probably explains the efficacy and the side effects associated with this drug...
October 25, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27795528/treatment-of-acute-graft-versus-host-disease
#10
Makoto Murata
Methylprednisolone administered at a dose of 2 mg/kg is a standard first-line systemic therapy for grade II to IV acute graft-versus-host disease (GVHD). Lower dose methylprednisolone or prednisone, at doses of 0.5-1.0 mg/kg, is also accepted as a first-line therapy for mild acute GVHD. Response rates of grade II to IV acute GVHD to systemic corticosteroid therapy in Japanese patients range from 40-70%, depending on the donors. No improvement within 5 days after first-line therapy or progression within 3 days after first-line therapy could make patients eligible for second-line treatment...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27788827/in%C3%A2-vitro-effects-of-thymoglobulin-in-human-embryonic-kidney-cell-line-hek293-in-culture
#11
F Jurenec, K Mihovilović, K Špiranec, A Sinđić, M Knotek
BACKGROUND: Anti-thymocyte globulins are polyclonal T-cell-depleting immunoglobulins used in induction of immunosuppression in kidney transplant recipients. Thymoglobulin is purified rabbit immunoglobulin (Ig)G, obtained by immunization of rabbits with fetal human thymus, which depletes T lymphocytes by complement-dependent lysis and apoptosis, reduces production of cytokines, and decreases expression of adhesion molecules in endothelial cells. METHODS: To determine possible direct effects of Thymoglobulin on kidney cells during transplantation, we used the Human Embryonic Kidney cell line (HEK293) in culture...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27779572/age-and-early-graft-function-relate-with-risk-benefit-ratio-of-allogenic-islet-transplantation-under-anti-thymocyte-globulin-mycophenolate-mofetil-tacrolimus-immune-suppression
#12
Da Hae Lee, Bart Keymeulen, Robert Hilbrands, Zhidong Ling, Ursule Van de Velde, Daniel Jacobs-Tulleneers-Thevissen, Geert Maleux, Bruno Lapauw, Laurent Crenier, Christophe De Block, Chantal Mathieu, Daniel Pipeleers, Pieter Gillard
BACKGROUND: Induction therapy with a T cell depleting agent followed by mycophenolate mofetil (MMF) and tacrolimus (Tac) is presently the most frequently used immune suppression (IS) regimen in islet transplantation. This study assesses its safety and tolerability in nonuremic type 1 diabetic recipients. METHODS: Fifty-one patients (ages between 29-63 years) with high glycemic variability and problematic hypoglycemia received intraportal islet grafts under anti-thymocyte globulin (ATG)-MMF-Tac protocol...
October 25, 2016: Transplantation
https://www.readbyqxmd.com/read/27775865/efficacy-and-safety-of-everolimus-plus-low-dose-tacrolimus-versus-mycophenolate-mofetil-plus-standard-dose-tacrolimus-in-de-novo-renal-transplant-recipients-12-month-data
#13
Y Qazi, D Shaffer, B Kaplan, D Y Kim, F L Luan, V R Peddi, F Shihab, S Tomlanovich, S Yilmaz, K McCague, D Patel, S Mulgaonkar
In this 12-month, multicenter, randomized, open-label, noninferiority study, de novo renal transplant recipients (RTxRs) were randomized (1:1) to receive everolimus plus low-dose tacrolimus (EVR+LTac) or mycophenolate mofetil plus standard-dose Tac (MMF+STac) with induction therapy (basiliximab or rabbit anti-thymocyte globulin). Noninferiority of composite efficacy failure rate (treated biopsy-proven acute rejection [tBPAR]/graft loss/death/loss to follow-up) in EVR+LTac versus MMF+STac was missed by 1.4%, considering the noninferiority margin of 10% (24...
October 24, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27771837/bacteremia-during-neutropenic-episodes-in-children-undergoing-hematopoietic-stem-cell-transplantation-with-ciprofloxacin-and-penicillin-prophylaxis
#14
Worawut Choeyprasert, Suradej Hongeng, Usanarat Anurathapan, Samart Pakakasama
Bacteremia during neutropenic episodes is a cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). We have used oral ciprofloxacin and penicillin V, from the start of the conditioning regimen until engraftment, for the prophylaxis of bacterial infection. The objective of this study was to retrospectively analyze the prevalence of and risk factors for breakthrough bacteremia during neutropenic episodes in autologous and allogeneic HSCT patients. There were 215 patients enrolled, with a median age of 8...
October 22, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27766064/characteristics-of-taiwanese-patients-of-pnh-in-the-international-pnh-registry
#15
Wen-Chien Chou, Wei-Han Huang, Ming-Chung Wang, Chao-Sung Chang, Shih-Peng Yeh, Tzeon-Jye Chiou, Yeu-Chin Chen, Tseng-Hsi Lin, Ming-Ching Shen
BACKGROUND: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and acquired hematopoietic stem cell disease, with florid clinical presentations. Although this disease has been characterized in the western countries, its clinical and laboratory features in Taiwan have not yet been reported. RESULTS: As a part of an international prospective, non-interventional, observational registration trial of PNH, we have analyzed 63 patients recruited between 2009 and 2015 in Taiwan, with comparison to the 3857 patients in the rest of the world (ROW)...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27758821/post-transplant-cyclophosphamide-versus-antithymocyte-globulin-as-graft-versus-host-disease-prophylaxis-in-haploidentical-transplant
#16
Annalisa Ruggeri, Yuqian Sun, Myriam Labopin, Andrea Bacigalupo, Francesca Lorentino, William Arcese, Stella Santarone, Zafar Gülbas, Didier Blaise, Giuseppe Messina, Ardeshi Ghavamzadeh, Florent Malard, Benedetto Bruno, Jose Luis Diez-Martin, Yener Koc, Fabio Ciceri, Mohamad Mohty, Arnon Nagler
Severe graft-versus-host-disease is a major barrier for non T-cell-depleted haploidentical stem cell transplantation and there is no consensus on the optimal GVHD prophylaxis. This study compared the two most commonly used graft-versus-host-disease prophylaxis regimens (post-transplant-cyclophosphamide-based (PTCY) versus the anti-thymocyte-globulin-based (ATG)) in adults with acute myeloid leukemia reported to the european society for blood and bone marrow transplantation. 308 patients were analyzed, 193 received PTCY and 115 ATG as anti- graft-versus-host-disease prophylaxis...
October 6, 2016: Haematologica
https://www.readbyqxmd.com/read/27742283/acute-graft-pyelonephritis-occurring-up-to-30-days-after-kidney-transplantation-epidemiology-risk-factors-and-survival
#17
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O L d'Avila, C E Poli-de-Figueiredo
Acute graft pyelonephritis is a very common infection in renal transplantation. The impact of acute graft pyelonephritis (AGPN) on graft and patient outcome has not yet been established. Eight hundred seventy kidney and kidney-pancreas transplants were retrospectively studied, over last 13 years, to verify occurrence of AGPN in the first 30 days post-transplantation. We found that 112 patients (15.8%) presented post-transplantatiom AGPN up to 30 days after a kidney transplantation. The occurrence was higher in older patients (P = ...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742282/does-thymoglobulin-induction-increase-susceptibility-to-carbapenem-resistant-acinetobacter-baumannii-sepsis-related-death-in-expanded-criteria-donors
#18
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O L d'Avila, C E Poli-de-Figueiredo
BACKGROUND: Solid organ transplant recipients are susceptible to antibiotic-resistant infections and carbapenem-resistant Acinetobacter baumannii (CRAB) has recently been recognized as a serious complication in solid organ recipients. High mortality rates have been described. METHODS: We retrospectively analyzed 807 transplantations and detected 10 patients who died 24 hours after the diagnosis of septicemia, all with CRAB-positive blood cultures. Recipients were followed up for at least 1 year and were stratified into the following groups: Group 1, patients alive; Group 2, patients that died due to other causes except Acinetobacter infection; and Group 3, patients who died within 24 hours of CRAB diagnosis...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27725585/aplastic-anemia
#19
Kensuke Usuki
Treatments of aplastic anemia are comprised of supportive therapy and aplastic anemia-specific therapy aimed at restoring hematopoiesis. Supportive therapies include transfusion, G-CSF, and the administration of iron chelation agents, as well as dealing specifically with individual symptoms. Aplastic anemia-specific treatments given with the aim of achieving hematopoietic recovery include immunosuppressive therapy, allogeneic hematopoietic stem cell transplantation, and anabolic hormone therapy. Although transplantation provides complete recovery of hematopoiesis (cure), there is a risk of death due to transplant-related complications...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27724812/tcr%C3%AE-%C3%AE-depleted-haploidentical-transplantation-results-in-adult-acute-leukemia-patients
#20
Leylagul Kaynar, Koray Demir, Esra Ermiş Turak, Çiğdem Pala Öztürk, Gökmen Zararsız, Zeynep Burçin Gönen, Selma Gökahmetoğlu, Serdar Şıvgın, Bülent Eser, Yavuz Köker, Musa Solmaz, Ali Ünal, Mustafa Çetin
INTRODUCTION: The use of αβ+ T-cell-depleted grafts is a novel approach to prevent graft failure, graft-versus-host disease (GVHD), and non-relapse mortality (NRM) in patients undergoing haploidentical hematopoietic stem cell transplantation. PATIENT AND METHOD: Thirty-four patients with acute leukemia and lacking a match donor were treated with αβ T-cell-depleted allografts from haploidentical family donors. A total of 24 patients had acute myeloid leukemia (AML) and 10 had acute lymphoblastic leukemia...
October 10, 2016: Hematology (Amsterdam, Netherlands)
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