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antithymocyte globulin

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https://www.readbyqxmd.com/read/28228650/haematopoietic-stem-cell-transplantation-for-autoimmune-diseases
#1
REVIEW
Joost F Swart, Eveline M Delemarre, Femke van Wijk, Jaap-Jan Boelens, Jürgen Kuball, Jacob M van Laar, Nico M Wulffraat
Autologous haematopoietic stem cell transplantation (HSCT) is the only treatment that is able to induce long-term, drug-free and symptom-free remission in several refractory autoimmune rheumatic diseases. Over 3,000 HSCT procedures for rheumatic and nonrheumatic severe autoimmune diseases have been performed worldwide. Specific conditioning regimens are currently used to eradicate the autoreactive immunological memory of patients. Although in vivo immune cell depletion with antithymocyte globulin or anti-CD52 is the norm for many regimens, ex vivo selection of CD34(+) stem cells from the graft is controversial...
February 23, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28178130/de-escalation-empirical-antibiotic-therapy-improved-survival-for-patients-with-severe-aplastic-anemia-treated-with-antithymocyte-globulin
#2
Rong Fu, Tong Chen, Jia Song, Guojin Wang, Lijuan Li, Erbao Ruan, Hui Liu, Yihao Wang, Huaquan Wang, Limin Xing, Yuhong Wu, Hong Liu, Wen Qu, Zonghong Shao
We aimed to investigate the efficacy and safety of de-escalation empirical therapy for controlling infection in patients with severe aplastic anaemia (SAA) treated with antithymocyte globulin (ATG). Eighty-seven ATG-treated SAA patients who had microbiological culture-confirmed infections from 2006 to 2015 in our center were retrospectively analyzed. The efficacy of de-escalation and non-de-escalation therapy was compared. Among all 87 patients, 63 patients were treated with de-escalation therapy and 24 patients with non-de-escalation therapy...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28137206/biopsy-proven-bk-virus-associated-nephropathy-clinico-pathologic-correlations
#3
Sarah Jahdali, Noura Al Oudah, Khaled O Alsaad, Hala Kfoury, Salem Qurashi, Abdulla Al Sayyari
OBJECTIVES: Our objective was to study the clinico-pathologic correlations in BK virus nephropathy. MATERIALS AND METHODS: We conducted a retrospective study of all patients with biopsy-proven polyoma (BK) virus infection. We compared their survival and renal outcomes versus BK virus-negative patients with biopsy-proven graft rejection. Histopathologic characterization by a blinded nephropathologist was performed. RESULTS: BK nephropathy was found in 10 patients biopsied for graft dysfunction...
January 30, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28122486/choice-of-induction-in-the-era-of-single-antigen-bead-testing-an-idiosyncratic-case-report
#4
Alexandre Hertig
Use of induction therapy after kidney transplant is based on immunologic risk status, but accurate assessment of risk in the era of advanced immunologic testing can be complex. Here, we describe the case of a young kidney recipient who had a Castleman disease, often regarded as a benign lymphoma. Our patient, a white male patient with Castleman disease, underwent a first kidney transplant with rabbit antithymocyte globulin induction but returned to dialysis after primary nonfunction occurred. A second donor became available who shared 3 class I HLA antigens with the first donor, but only low-level isolated donor-specific antibodies toward HLA-Cw were detected (mean fluorescence intensity < 1000)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28107198/meta-analysis-of-the-actions-of-antithymocyte-globulin-in-patients-undergoing-allogeneic-hematopoietic-cell-transplantation
#5
Jiaojiao Yuan, Renzhi Pei, Wensi Su, Junjie Cao, Ying Lu
Graft-versus-host disease (GVHD) is a serious complication associated with allogeneic hematopoietic cell transplantation (allo-HCT). Antithymocyte globulin (ATG) is widely used prior to allo-HCT for GVHD prevention, though evidence of its efficacy remains unclear. We therefore identified nine randomized controlled trials (RCTs), enrolling 1089 patients (554 in the ATG group and 535 in the non-ATG group) to conduct a meta-analysis of the actions of ATG in allo-HCT. A relative risk or risk ratio (RR) and 95% confidence interval (CI) were calculated for each outcome...
January 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28100318/-clinical-characteristics-of-clonal-evolution-after-immunosuppressive-therapy-in-children-with-severe-very-severe-aplastic-anemia
#6
Jing-Liao Zhang, Tian-Feng Liu, Li-Xian Chang, Xia Chen, Yuan-Yuan Ren, Cong-Cong Sun, Chao Liu, Wen-Bin An, Yang Wan, Xiao-Juan Chen, Wen-Yu Yang, Shu-Chun Wang, Ye Guo, Yao Zou, Yu-Mei Chen, Xiao-Fan Zhu
OBJECTIVE: To evaluate the clinical characteristics and risk factors of clonal evolution after immunosuppressive therapy (IST) in children with severe/very severe aplastic anemia (SAA/VSAA). METHODS: The clinical data of 231 children with newly-diagnosed SAA/VSAA who received IST were retrospectively studied. The incidence and risk factors of clonal evolution after IST were analyzed. RESULTS: The 5-year overall survival rate of the 231 patients was 82...
January 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28088952/-comparison-of-clinical-outcomes-between-antithymocyte-globulin-and-basiliximab-in-renal-transplantation-from-donation-after-citizen-death-a-matched-pair-study
#7
K L Lin, L Zhu, C Fu, Z B Lin, G Chen
Objective: To compare the safety and effectiveness between antithymocyte globulin (ATG) and basiliximab in deceased donor renal transplantation within matched groups where paired recipients received graft donations from same donors. Methods: A total of 124 cases of deceased donor kidney transplantation performed at Wuhan Tongji Hospital from January 2013 to November 2015 were retrospectively analyzed. Based upon their induction therapies, the recipients receiving graft donations from same donors were divided into two groups, namely ATG group (n=62) and basiliximab group (n=62)...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28078653/meta-analysis-of-treatment-with-rabbit-and-horse-antithymocyte-globulin-for-aplastic-anemia
#8
Jin Hayakawa, Junya Kanda, Yu Akahoshi, Naonori Harada, Kazuaki Kameda, Tomotaka Ugai, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Masahiro Ashizawa, Miki Sato, Kiriko Terasako-Saito, Shun-Ichi Kimura, Misato Kikuchi, Rie Yamazaki, Shinichi Kako, Yoshinobu Kanda
Aplastic anemia patients who received rabbit antithymocyte globulin exhibited response and survival rates inferior to those who received horse antithymocyte globulin in several studies. Therefore, we conducted a meta-analysis to compare rabbit and horse antithymocyte globulin as immunosuppressive therapy for aplastic anemia. We searched online databases for studies that compared antithymocyte globulin regimens as first-line treatment for aplastic anemia, including both randomized and non-randomized controlled trials...
January 11, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28073178/polyclonal-and-monoclonal-antibodies-for-induction-therapy-in-kidney-transplant-recipients
#9
REVIEW
Penny Hill, Nicholas B Cross, A Nicholas R Barnett, Suetonia C Palmer, Angela C Webster
BACKGROUND: Prolonging kidney transplant survival is an important clinical priority. Induction immunosuppression with antibody therapy is recommended at transplantation and non-depleting interleukin-2 receptor monoclonal antibodies (IL2Ra) are considered first line. It is suggested that recipients at high risk of rejection should receive lymphocyte-depleting antibodies but the relative benefits and harms of the available agents are uncertain. OBJECTIVES: We aimed to: evaluate the relative and absolute effects of different antibody preparations (except IL2Ra) when used as induction therapy in kidney transplant recipients; determine how the benefits and adverse events vary for each antibody preparation; determine how the benefits and harms vary for different formulations of antibody preparation; and determine whether the benefits and harms vary in specific subgroups of recipients (e...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28018447/targeted-busulfan-and-fludarabine-based-conditioning-for-bone-marrow-transplantation-in-chronic-granulomatous-disease
#10
Hee Young Ju, Hyoung Jin Kang, Che Ry Hong, Ji Won Lee, Hyery Kim, Sang Hoon Song, Kyung-Sang Yu, In-Jin Jang, June Dong Park, Kyung Duk Park, Hee Young Shin, Joong-Gon Kim, Hyo Seop Ahn
Chronic granulomatous disease (CGD) is a primary immunodeficiency disease caused by impaired phagocytic function. Hematopoietic stem cell transplantation (HSCT) is a definitive cure for CGD; however, the use of HSCT is limited because of associated problems, including transplantation-related mortality and engraftment failure. We report a case of a patient with CGD who underwent successful HSCT following a targeted busulfan and fludarabine reduced-toxicity myeloablative conditioning. Intravenous busulfan was administered once daily for 4 consecutive days (days -8 to -5), and the target area under the curve was 75,000 µg·hr/L...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28012219/incorporation-of-high-dose-131-i-metaiodobenzylguanidine-treatment-into-killer-immunoglobulin-like-receptor-hla-ligand-mismatched-haploidentical-stem-cell-transplantation-for-children-with-neuroblastoma-who-failed-tandem-autologous-stem-cell-transplantation
#11
Ji Won Lee, Eun-Suk Kang, Ki Woong Sung, Eunsang Yi, Soo Hyun Lee, Keon Hee Yoo, Hong Hoe Koo
BACKGROUND: We performed a pilot study (NCT 00793351) to evaluate the effectiveness and feasibility of a strategy incorporating high-dose (131) I-metaiodobenzylguanidine (HD-MIBG) treatment into killer immunoglobulin-like receptor (KIR)/HLA-ligand mismatched haploidentical stem cell transplantation (haplo-SCT) in improving the survival of children with neuroblastoma who failed previous tandem autologous SCT. PROCEDURE: If the patient remained progression free with salvage treatment, HD-MIBG treatment (18 mCi/kg) was given prior to reduced-intensity conditioning (cyclophosphamide + fludarabine + antithymocyte globulin)...
December 24, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27973435/antithymocyte-globulin-induces-a-tolerogenic-phenotype-in-human-dendritic-cells
#12
Tobias Roider, Michael Katzfuß, Carina Matos, Katrin Singer, Kathrin Renner, Peter J Oefner, Katja Dettmer-Wilde, Wolfgang Herr, Ernst Holler, Marina Kreutz, Katrin Peter
Antithymocyte globulin (ATG) is used in the prevention of graft-versus-host disease during allogeneic hematopoietic stem cell transplantation. It is generally accepted that ATG mediates its immunosuppressive effect primarily via depletion of T cells. Here, we analyzed the impact of ATG-Fresenius (now Grafalon(®)) on human monocyte-derived dendritic cells (DC). ATG induced a semi-mature phenotype in DC with significantly reduced expression of CD14, increased expression of HLA-DR, and intermediate expression of CD54, CD80, CD83, and CD86...
December 11, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27957357/total-body-irradiation-without-chemotherapy-as-conditioning-for-an-allogeneic-hematopoietic-cell-transplantation-for-adult-acute-myeloid-leukemia
#13
Sultan Altouri, Mitchell Sabloff, David Allan, Harry Atkins, Lothar Huebsch, Dawn Maze, Rajiv Samant, Christopher Bredeson
Current therapies for acute myeloid leukemia (AML), failing induction, are rarely effective. We report our experience in 4 patients with AML who received 16 Gy TBI prior to allogeneic hematopoietic cell transplantation (alloHCT), between June 2010 and May 2011. Patients were 20 to 55 years of age, 2 with relapsed disease and 2 with AML failing induction. An HLA-matched graft from related or unrelated donor was infused on day 0. All but one, who received a CD34(+)-selected graft, received methotrexate and tacrolimus +/- antithymocyte globulin, as GVHD prophylaxis...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27951736/efficacy-of-antithymocyte-globulin-for-allogeneic-hematopoietic-cell-transplantation-a-systematic-review-and-meta-analysis
#14
Yasuyuki Arai, Tomoyasu Jo, Hiroyuki Matsui, Tadakazu Kondo, Akifumi Takaori-Kondo
The efficacy of rabbit antithymocyte globulin (ATG) for the prevention of graft-versus-host disease (GVHD) has been evaluated in several randomized control trials, but the results show some discrepancies. Therefore, we performed a systematic review and meta-analysis covering the latest RCTs including six trials (total 845 patients). The incidence of acute and chronic GVHD was significantly lower in the ATG arms (risk ratio, 0.75 and 0.54, respectively). No significant differences were found regarding overall survival, the incidence of relapse, and non-relapse mortality; however, the incidence of cytomegalovirus and Epstein-Barr virus reactivation increased (risk ratio, 1...
December 12, 2016: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/27941773/haploidentical-transplantation-for-pediatric-patients-with-acquired-severe-aplastic-anemia
#15
L P Xu, X H Zhang, F R Wang, X D Mo, T T Han, W Han, Y H Chen, Y Y Zhang, J Z Wang, C H Yan, Y Q Sun, S N Zuo, X J Huang
Techniques for haploidentical hematopoietic stem cell transplantation (haplo-HSCT) to treat severe aplastic anemia (SAA) have recently improved, but no protocol has been evaluated in a large number of pediatric patients. Fifty-two children with SAA received haplo-HSCT in our center. The treatment protocol used G-CSF-primed bone marrow with G-CSF-mobilized PBSCs without in vitro T-cell depletion. The conditioning regimen included busulfan/cyclophosphamide and antithymocyte globulin. Fifty-one patients achieved primary engraftment; one child died of regimen-related toxicity on the day +1...
December 12, 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27941764/gvhd-after-umbilical-cord-blood-transplantation-for-acute-leukemia-an-analysis-of-risk-factors-and-effect-on-outcomes
#16
Y-B Chen, T Wang, M T Hemmer, C Brady, D R Couriel, A Alousi, J Pidala, A Urbano-Ispizua, S W Choi, T Nishihori, T Teshima, Y Inamoto, B Wirk, D I Marks, H Abdel-Azim, L Lehmann, L Yu, M Bitan, M S Cairo, M Qayed, R Salit, R P Gale, R Martino, S Jaglowski, A Bajel, B Savani, H Frangoul, I D Lewis, J Storek, M Askar, M A Kharfan-Dabaja, M Aljurf, O Ringden, R Reshef, R F Olsson, S Hashmi, S Seo, T R Spitzer, M L MacMillan, A Lazaryan, S R Spellman, M Arora, C S Cutler
Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1404 umbilical cord blood transplantation (UCBT) patients (single (<18 years)=810, double (⩾18 years)=594) with acute leukemia to define the incidence of acute GvHD (aGvHD) and chronic GvHD (cGvHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grade II-IV aGvHD was 39% (95% confidence interval (CI), 36-43%), grade III-IV aGvHD was 18% (95% CI, 15-20%) and 1-year cGvHD was 27% (95% CI, 24-30%)...
December 12, 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27938318/incisional-infections-after-renal-transplant-outcome-data-from-238-consecutive-recipients
#17
Demetrios Moris, Spyridon Davakis, Kiriaki Kakavia, John Bokos, Spyridon Vernadakis, Konstantinos Diles, Georgios Sotirchos, Alexandros Barlas, Mina Psychogiou, Georgios Zavos
OBJECTIVES: Surgical incision infections, along with urinary tract infections, are among the most common infective complications after kidney transplant. The aim of this retrospective study is to evaluate the incidence and predisposing factors of surgical incision infection development in renal transplant recipients. MATERIALS AND METHODS: Between 1 January 2012 and 31 December 2015, there were 238 consecutive kidney transplant procedures performed in our unit. Of these, 146 patients received deceased donor kidney allografts and 92 had transplants from living related donors...
December 12, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27931587/do-prior-driveline-infections-increase-the-risk-of-infection-in-heart-transplant-patients-treated-with-rabbit-antithymocyte-globulin-induction-therapy
#18
D Arman, D Kuraitis, J Moriguchi, M Hamilton, F Liou, S Siddiqui, M Luu, P Zakowski, F Arabia, J Kobashigawa
BACKGROUND: The use of mechanical circulatory support devices (MCSDs) has been increasing over the past several years. Driveline infections (DLIs) are one of the most common complications seen in these patients; reportedly, up to 50% of patients with MCSDs can develop this complication. It is believed that the removal of the driveline results in treatment of the localized infection area. MCSD patients are also known to develop circulating antibodies. These circulating antibodies have been associated with poor outcomes after heart transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27888015/early-and-long-term-impaired-t-lymphocyte-immune-reconstitution-after-cord-blood-transplantation-with-antithymocyte-globulin
#19
Nerea Castillo, Irene García-Cadenas, Pere Barba, Carme Canals, Cristina Díaz-Heredia, Rodrigo Martino, Christelle Ferrà, Isabel Badell, Izaskun Elorza, Jorge Sierra, David Valcárcel, Sergio Querol
Immune reconstitution is crucial to the success of allogeneic hematopoietic stem cell transplantation. Umbilical cord blood transplantation (UCBT) has been associated with delayed immune reconstitution. We characterized the kinetics and investigated the risk variables affecting recovery of the main lymphocyte subsets in 225 consecutive pediatric and adult patients (males, n = 126; median age, 15; range, .3 to 60; interquartile range, 4 to 35) who underwent myeloablative single UCBT between 2005 and 2015 for malignant and nonmalignant disorders...
March 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#20
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
17, 2016: Lancet
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