Low dose anti-thymocyte globulin with low dose posttransplant cyclophosphamide (low dose ATG/PTCy) can reduce the risk of graft-versus-host disease as compared with standard-dose anti-thymocyte globulin in haploidentical peripheral hematopoietic stem cell transplantation combined with unrelated cord blood

作者：Xiaoqian Xu, Jun Yang, Yu Cai, Li Su, Jiahua Niu, Kun Zhou, Ying Jiang, Xiaowei Xu, Chang Shen, Chongmei Huang, Huiying Qiu, Daolin Wei, Mei Kang, Yin Tong, Zheng Wei, Peng Liu, Liping Wan, Xianmin Song · 发表于：Bone Marrow Transplantation · 年份：2020 · DOI：10.1038/s41409-020-01047-2 · 被引用次数：42 · 研究领域：Hematopoietic Stem Cell Transplantation、T-cell and B-cell Immunology、Immunotherapy and Immune Responses

For successful transplantation using a haploidentical donor, it requires effective depletion of T cells to reduce the risk of graft-versus-host disease (GvHD) and prevent serious GvHD. Contemporary practice of haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) frequently adopts in vivo T-cell depletion strategies: a monoclonal antibody against T cells using antihuman thymocyte immunoglobulin (ATG) [ 1 , 2 ] or posttransplant cyclophosphamide (PTCy) based regimen [ 3 , 4 ]. The ATG-based regimen was one of the most commonly used GvHD prophylaxis for Haplo-HSCT in China but remaining an issue of higher risk of acute GvHD (aGvHD) up to 40% incidence [ 1 , 2 ] as well as cytomegalovirus (CMV) and Epstein–Barr virus (EBV) infection. PTCy-based regimen had outstanding outcomes of GvHD prevention in Haplo-HSCT with bone marrow grafts with 21–34% of incidences of grades II–IV aGvHD. However, by substituting BM graft with peripheral blood stem cell (PBSC) grafts, the incidence of grades II–IV aGvHD increased in Haplo-HSCT even after the use of PTCy-based regimens for GvHD prophylaxis [ 5 , 6 ]. Accordingly, there is room for further improvement of GvHD reduction when the haploidentical transplant was performed using a PBSC graft. Thus there is a practical demand for more powerful GvHD prophylaxis for haploidentical peripheral blood stem cell transplantation (Haplo-PBSCT) beyond ATG-based or PTCy-based regimens. Recently, we have applied a novel regimen of combining lo...