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. 2018 Jan 14;39(1):22-27.
doi: 10.3760/cma.j.issn.0253-2727.2018.01.005.

[Clinical efficacy and safety of porcine antihuman lymphocyte immunoglobulin in alternative donor allogeneic hematopoietic cell transplantation for severe aplastic anemia]

[Article in Chinese]
X Chen  1 , J L Wei, Y Huang, E L Jiang, Q L Ma, W H Zhai, Y He, R L Zhang, D L Yang, J F Yao, G X Zhang, S Z Feng, M Z Han
Affiliations

[Clinical efficacy and safety of porcine antihuman lymphocyte immunoglobulin in alternative donor allogeneic hematopoietic cell transplantation for severe aplastic anemia]

[Article in Chinese]
X Chen et al. Zhonghua Xue Ye Xue Za Zhi. .

Abstract
in English, Chinese

Objective: To compare eficacy and safety of porcine antihuman lymphocyte immunoglobulin (pALG) and rabbit antithymocyte immunoglobulin (rATG) as a part of alternative donor allogeneic hematopoietic stem cell transplantation (AD allo-HSCT) for severe aplastic anemia (SAA). Methods: The clinical data of 46 SAA patients received AD allo-HSCT from January 2006 to November 2016 were retrospectively analyzed. The cohort of patients were divided into two groups based on rATG or pALG as a part of conditioning regimen to compare implantation rate, transplantation related complications and outcome. Results: In rATG group 30 patients achieved ANC reconstitution, 27 patients achieved PLT reconstitution. In pALG group all 16 patients achieved ANC and PLT reconstitutions. There were no significant differences between the two groups in terms of acute graft-versus-host disease (aGVHD) (P=0.475), Ⅲ-Ⅳ grade aGVHD (P=0.876), chronic GVHD (cGVHD) (P=0.309), extensive cGVHD (P=0.687), graft rejection (GR) (P=0.928), bloodstream infection (P=0.443), invasive fungal disease (P=0.829), cytomegalovirus viremia (P=0.095) respectively. Prospective 5-year overall survival (OS) in rATG and pALG groups were (75.1±8.2)% and (53.6±13.3)% with median follow-up of 14(2-102) and 23(4-63) months, respectively (P=0.190). Conclusion: As a part of conditioning regimen, pALG could achieve similar efficacy as rATG, without increasing the incidences of transplantation complications such as GVHD, GR and infection, in the setting of AD allo-HSCT for SAA patients.

目的： 比较预处理方案含猪抗人淋巴细胞免疫球蛋白（pALG）或兔抗人胸腺细胞免疫球蛋白（rATG）替代供者异基因造血干细胞移植（AD allo-HSCT）治疗重型再生障碍性贫血（SAA）患者的疗效及安全性。 方法： 回顾性分析2006年1月至2016年11月46例接受AD allo-HSCT SAA患者的临床资料，按预处理方案包含rATG或pALG分为两组，比较两组植入率、移植相关并发症发生率及转归。 结果： rATG组30例患者均获得粒细胞植入，27例患者获得血小板植入。pALG组16例患者粒细胞及血小板均植入。两组患者在移植后急性移植物抗宿主病（aGVHD）（P=0.475）、Ⅲ~Ⅳ度aGVHD（P=0.876）、慢性移植物抗宿主病（cGVHD）（P=0.309）、广泛型cGVHD（P=0.687）、移植物排斥（GR）（P=0.928）、血流感染（P=0.443）、侵袭性真菌病（P=0.829）、巨细胞病毒血症（P=0.095）发生率方面差异均无统计学意义。rATG组中位随访14（2~102）个月，预期5年总生存率为（75.1±8.2）%；pALG组中位随访23（4~63）个月，预期5年总生存率为（53.6±13.3）%，差异无统计学意义（P=0.190）。 结论： SAA患者行AD allo-HSCT，预处理方案应用pALG可取得与rATG相近疗效，且并不增加GVHD、GR及感染等移植后并发症的发生率。.

Keywords: Anemia, aplastic, severe; Donor, alternative; Hematopoietic stem cell transplantation; Porcine antihuman lymphocyte immunoglobulin.

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Figures

图1
图1. 预处理方案含rATG与含pALG重型再生障碍性贫血患者替代供者异基因造血干细胞移植后生存分析
rATG：兔抗人胸腺细胞免疫球蛋白；pALG：猪抗人淋巴细胞免疫球蛋白
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