Quality of life of patients after allogeneic hematopoietic stem cell transplantation with antihuman thymocyte globulin

Zheng-Ping Yu, Jia-Hua Ding, Fen Wu, Jin Liu, Jun Wang, Jian Cheng, Gang Zhao
Biology of Blood and Marrow Transplantation 2012, 18 (4): 593-9
The utility of graft-versus-host disease (GVHD) prophylaxis with cyclosporine (CSA), methotrexate (MTX), and antihuman thymocyte globulin (ATG) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) exists in the literature; however, up to now, it has not yet been fully described. This study was to observe the influence of adding ATG on GVHD prophylaxis and the quality of life (QoL) of 96 hemopathic patients after allo-HSCT. We retrospectively analyzed the outcomes of 96 consecutive patients undergoing allo-HSCT, including 54 patients who received ATG regimen without in vitro T cell depletion (TCD) (ATG group) and 42 patients who received neither ATG regimen nor TCD (control group). All patients were followed up, and the factors, including age, sex, HLA and ABO compatibility, related and unrelated donors, and disease status, were undertaken to analysis. All patients in the study achieved trilineage engraftment with full-donor chimerism. The cumulative incidence of acute GVHD (aGVHD) was lower in the ATG group than that in the control group (29.6% versus 57.1%, P = .006), and the cumulative incidence of chronic GVHD (cGVHD) was 35.2% for patients with ATG and 66.7% for patients without ATG (P < .01). Notably, the proportion of patients with Karnofsky scores of >90 was 70.4% in the patients with ATG, and 28.6% in the patients without ATG (P < .001). Furthermore, the cumulative incidence of patients with opportunistic infection was significantly different in both groups posttransplantation, with 44.4% and 19.1% in recipient patients with or without ATG respectively (P < .05). Additional usage of ATG not only decreases the occurrence of aGVHD and cGVHD, but also improves QoL of patients after allo-HSCT without affecting stem cell engraftment or overall survival.

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