摘要

BACKGROUND:Graft-versus-host disease (GVHD) is one of the leading causes of non-relapse mortality and morbidity after allogeneic hematopoietic stem cell transplantation (allo-HCT).
METHODS:We evaluated the outcomes of two well-established strategies used for GVHD prevention: in vivo T cell depletion using antithymocyte globulin (ATG) and ex vivo T cell depletion using a CD34-selected (CD34+) graft. A total of 525 adult patients (363 ATG, 162 CD34+) with intermediate or high-risk cytogenetics acute myeloid leukemia (AML) in first complete remission (CR1) were included. Patients underwent myeloablative allo-HCT using matched related or unrelated donors.
RESULTS:Two-year overall survival estimate was 69.9% (95% CI, 58.5-69.4) in the ATG group and 67.6% (95% CI, 60.3-74.9) in the CD34+ group (p = 0.31). The cumulative incidence of grade II-IV acute GVHD and chronic GVHD was higher in the ATG cohort [HR 2.0 (95% CI 1.1-3.7), p = 0.02; HR 15.1 (95% CI 5.3-42.2), p 

译文

背景: 移植物抗宿主病 (GVHD) 是异基因造血干细胞移植 (allo-HCT) 后非复发死亡率和发病率的主要原因之一。
方法: 我们评估了用于 GVHD 预防的两种成熟策略的结果: 使用抗胸腺细胞球蛋白 (ATG) 的体内 T 细胞耗竭和使用 CD34-selected (CD34) 的体外 T 细胞耗竭嫁接。共有 525 名处于首次完全缓解 (CR1) 的中度或高风险细胞遗传学急性髓系白血病 (AML) 的成年患者 (363 ATG，162 CD34) 被纳入其中。患者使用匹配的相关或无关供体进行清髓性 allo-HCT。
结果: ATG 组两年总生存估计值为 69.9% (95% CI，58.5-69.4)，ATG 组为 67.6% (95% CI，60.3-74.9) 在 CD34 集团 (p   0 =。 31)。在 ATG 队列中，II-IV 级急性 GVHD 和慢性 GVHD 的累积发生率较高 [HR 2.0 (95% CI 1.1-3.7)，p = ¼ 0。 02; HR 15.1 (95% CI 5.3-42.2)，p