Graft-versus-host Disease Prophylaxis With Abatacept Reduces Severe Acute Graft-versus-host Disease in Allogeneic Hematopoietic Stem Cell Transplant for Beta-thalassemia Major With Busulfan, Fludarabine, and Thiotepa.
Transplantation
; 105(4): 891-896, 2021 04 01.
Article
em En
| MEDLINE
| ID: mdl-32467478
ABSTRACT
BACKGROUND:
We hypothesized that the addition of 4 doses of abatacept to our standard acute graft-versus-host disease (GVHD) prophylaxis would reduce the incidence of day +100 severe acute GVHD in children with transfusion-dependent beta-thalassemia major undergoing a myeloablative allogeneic hematopoietic stem cell transplant (HSCT), without impacting engraftment.METHODS:
Twenty-four children with beta-thalassemia major received abatacept at a dose of 10 mg/kg intravenously on days -1, +5, +14, and +28 after HSCT in addition to calcineurin inhibitors and methylprednisolone. Outcomes were compared to 8 beta-thalassemia patients who received standard acute GVHD prophylaxis.RESULTS:
There was no difference in engraftment between the 2 groups. No patient had grades III-IV acute GVHD by day +100 in the abatacept cohort compared with 50% in the standard acute GVHD prophylaxis group (P = 0.001). Viral reactivation occurred in 5 children in the standard acute GVHD cohort and in 20 children in the abatacept cohort (P = 0.2). Thalassemia-free survival after HSCT was 100% in the abatacept cohort compared to 62.5% in the standard cohort at last follow-up (P = 0.007).CONCLUSIONS:
Adding abatacept to our routine GVHD prophylaxis reduced the incidence of day +100 severe acute GVHD without impacting engraftment or survival.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Vidarabina
/
Bussulfano
/
Tiotepa
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Talassemia beta
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Transplante de Células-Tronco Hematopoéticas
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Condicionamento Pré-Transplante
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Abatacepte
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Doença Enxerto-Hospedeiro
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Imunossupressores
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article