Background
Methods
Patients and study design
Immunophenotyping analysis
Statistical analysis
Results
Characteristics of patients
ATG-6 | ATG-10 |
P value | |
---|---|---|---|
Subjects, n | 29 | 31 | |
Age, years, median (range) | 22 (16–48) | 29 (15–48) | 0.11 |
Gender, n (%) | |||
Male | 18 (62.1) | 24 (77.4) | 0.19 |
Female | 11 (37.9) | 7 (22.6) | |
Diagnosis, n (%) | |||
AML | 12 (41.4) | 14 (45.2) | 0.77 |
ALL | 12 (41.4) | 12 (38.7) | |
CML | 2 (6.9) | 3 (9.6) | |
MDS (RAEB) | 3 (10.3) | 2 (6.5) | |
CD34+ cells in graft, ×106/kg, median (range) | 2.4 (0.7–4.9) | 3.1 (0.3–7.8) | 0.32 |
Donor type | Related donors | ||
HLA typing | 1–3/6 Mismatch | ||
Stem cell source | BM + PB | ||
Conditioning regimen | BU + CY + ATG | ||
GVHD prophylaxis | CSA + MMF + MTX |
Recoveries of T lymphocyte subpopulations were delayed with 10 mg/kg ATG
Group | WBC | Lymphocyte | |
---|---|---|---|
Day 30 | ATG-6 | 5.9 (1.6–15.7) | 0.3 (0.1–2.7) |
ATG-10 | 4.7 (2.0–18.1) | 0.3 (0.1–2.3) | |
p value | 0.95 | 0.47 | |
Day 60 | ATG-6 | 4.9 (1.9–14.9) | 1.1 (0.3–3.3) |
ATG-10 | 4.3 (0.1–26.1) | 0.9 (0.0–10.8) | |
p value | 0.46 | 0.57 | |
Day 90 | ATG-6 | 4.5 (1.7–11.2) | 1.6 (0.2–3.2) |
ATG-10 | 3.8 (1.0–9.5) | 1.2 (0.2–6.2) | |
p value | 0.27 | 0.34 | |
Day 180 | ATG-6 | 5.2 (2.8–8.7) | 2.0 (0.9–3.9) |
ATG-10 | 4.9 (0.5–7.2) | 1.8 (0.2–4.8) | |
p value | 0.54 | 0.36 | |
Day 360 | ATG-6 | 5.8 (3.8–15.0) | 2.4 (0.4–5.2) |
ATG-10 | 5.4 (2.0–9.6) | 2.2 (0.9–4.7) | |
p value | 0.58 | 0.88 |
Group | CD19+
| CD3+
| CD4+
| CD8+
| CD4+CD45RA+
| CD4+CD45RO+
| CD4+CD28+
| CD8+CD28+
| CD4−CD8−
| |
---|---|---|---|---|---|---|---|---|---|---|
Day 30 | ATG-6 | 10.7 (0.3–28.1) | 195.9 (7.8–1488) | 47.6 (0.9–246) | 104.8 (5.2–1273) | 43.7 (0.6–207) | 0.4 (0.0–3.1) | 57.5 (0.7–1091) | 48.3 (1.1–227) | 21.9 (1.6–81.6) |
ATG-10 | 5.9 (0.4–406) | 149.5 (2.1–1433) | 20.1 (0.2–272) | 82.7 (0.1–1283) | 20.0 (0.0–268) | 0.2 (0.0–2.3) | 26.6 (0.1–736) | 19.9 (0.1–260) | 10.9 (0.9–92.7) | |
p value | 0.07 | 0.07 | 0.02 | 0.10 | 0.01 | 0.03 | 0.02 | 0.01 | 0.03 | |
Day 60 | ATG-6 | 15.9 (1.2–140) | 940.8 (60.3–3406) | 140.3 (20.2–1051) | 722.0 (53.0–2666) | 125.8 (17.8–763) | 1.6 (0.1–19.0) | 151.7 (0.4–922) | 111.3 (1.1–481) | 51.5 (1.6–369) |
ATG-10 | 13.1 (0.3–3778) | 691.6 (24.8–6765) | 81.2 (1.8–813) | 533.9 (20.7–5262) | 78.2 (1.6–704) | 0.6 (0.0–94.7) | 159.6 (4.1–2580) | 72.9 (1.7–892) | 22.1 (0.3–703) | |
p value | 0.54 | 0.53 | 0.04 | 0.71 | 0.03 | 0.04 | 0.39 | 0.05 | 0.02 | |
Day 90 | ATG-6 | 15.2 (2.8–102) | 1127.2 (146–2859) | 187.965 (27.2–810) | 784.2 (62.6–2505) | 159.6 (2.3–521) | 1.2 (0.0–19.8) | 195.8 (14.1–732) | 106.9 (36.8–357) | 64.7 (8.0–313) |
ATG-10 | 9.1 (0.3–356) | 885.6 (0.2–5688) | 113.4 (15.7–1162) | 697.3 (0.2–4404) | 109.4 (14.4–911) | 0.7 (0.1–24.2) | 116.7 (0.0–1054) | 62.5 (0.0–496) | 33.5 (0.0–182) | |
p value | 0.27 | 0.26 | 0.09 | 0.78 | 0.14 | 0.23 | 0.29 | 0.02 | 0.04 | |
Day 180 | ATG-6 | 62.0 (2.5–384) | 1423 (333–3543) | 256.2 (67.1–951) | 1092 (171–2995) | 206.5 (58.2–675) | 2.6 (0.8–58.8) | 185.9 (71.6–521) | 224.5 (62.1–362) | 83.9 (23.1–1284) |
ATG-10 | 61.6 (0.4–322) | 1374 (106–4317) | 244.5 (24.5–707) | 1091 (75.9–3714) | 210.0 (22.2–614) | 3.0 (0.1–14.5) | 161.1 (0.3–727) | 131.8 (2.8–343) | 39.8 (5.4–195) | |
p value | 0.68 | 0.39 | 0.49 | 0.99 | 0.73 | 0.68 | 0.32 | 0.06 | 0.01 | |
Day 360 | ATG-6 | 204.5 (23.0–689) | 1688 (803–4680) | 355.9 (178–1061) | 1170 (367.7–4007) | 271.8 (147–512) | 4.6 (0.8–11.7) | 229.3 (96.8–463) | 294.9 (146–1134) | 80.4 (10.0–883) |
ATG-10 | 82.7 (6.2–787) | 1620 (625–4994) | 261.3 (55.1–1579) | 1018 (425–3308) | 224.1 (54.4–1449) | 4.8 (0.3–56.7) | 173.8 (48.8–459) | 200.3 (46.8–571) | 78.2 (8.6–1297) | |
p value | 0.23 | 0.83 | 0.23 | 0.92 | 1.00 | 0.34 | 0.18 | 0.02 | 0.98 |
High dose ATG conditioning was associated with a lower incidence of acute GVHD but increased EBV reactivation after haploHSCT
ATG-6 | ATG-10 |
p value | |
---|---|---|---|
Acute GVHD, n (%) | |||
Total | 21 (72.4) | 14 (45.2) | 0.03 |
Grade II–IV | 11 (37.9) | 8 (25.8) | 0.32 |
Grade III–IV | 4 (13.8) | 2 (6.5) | 0.35 |
Median day of onset grade II-IV aGVHD (range) | 29 (10–42) | 30 (9–80) | 0.32 |
CMV reactivation, n (%) | 22 (75.9) | 24 (77.4) | 0.89 |
Median day of onset CMV reactivation (range) | 36 (22–77) | 37.5 (22–102) | 0.73 |
EBV reactivation, n (%) | 2 (6.9) | 10 (32.2) | 0.02 |
Median day of onset EBV reactivation (range) | 60.5 (47–74) | 51 (22–102) | 0.61 |
Recovery of CD4−CD8− T cells was negatively correlated with EBV reactivation after 10 mg/kg ATG conditioning
Day 30 | Day 60 | Day 90 | Day 180 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EBV | T-cell subsets | CD4+
| CD4+CD45RA+
| CD4+CD45RO+
| CD8+CD28+
| CD4−CD8−
| CD4+
| CD4+CD45RA+
| CD4+CD45RO+
| CD8+CD28+
| CD4−CD8−
| CD8+CD28+
| CD4−CD8−
| CD8+CD28+
| CD4−CD8−
|
Correlation coefficient | −0.216 | −0.242 | −0.212 | −0.208 | −0.378 | 0.088 | 0.063 | 0.021 | 0.130 | −0.122 | −0.020 | −0.352 | 0.105 | −0.021 | |
Sig. (2-tailed) | 0.243 | 0.189 | 0.252 | 0.261 | 0.036 | 0.643 | 0.741 | 0.912 | 0.493 | 0.521 | 0.921 | 0.066 | 0.580 | 0.912 |
Day 30 | Day 60 | Day 90 | Day 180 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EBV | T−cell subsets | CD4+
| CD4+CD45RA+
| CD4+CD45RO+
| CD8+CD28+
| CD4−CD8−
| CD4+
| CD4+CD45RA+
| CD4+CD45RO+
| CD8+CD28+
| CD4−CD8−
| CD8+CD28+
| CD4−CD8−
| CD8+CD28+
| CD4−CD8−
|
Correlation coefficient | −0.214 | −0.213 | −0.300 | −0.224 | −0.313 | −0.035 | −0.074 | −0.071 | −0.011 | −0.212 | −0.104 | −0.318 | 0.008 | −0.142 | |
Sig. (2-tailed) | 0.100 | 0.102 | 0.020 | 0.086 | 0.015 | 0.800 | 0.589 | 0.605 | 0.939 | 0.117 | 0.456 | 0.019 | 0.954 | 0.306 |