Antithymocyte Globulin Pharmacokinetics in Pediatric Patients After Hematopoietic Stem Cell Transplantation
- 1 October 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Pediatric Hematology/Oncology
- Vol. 27 (10), 532-536
- https://doi.org/10.1097/01.mph.0000184575.00717.25
Abstract
To analyze the dose effects of rabbit-derived antithymocyte globulin (ATG) in children after allogeneic hematopoietic stem cell transplantation (HSCT), ATG serum levels were monitored in 32 children and adolescents (median age 3.42 years, range 0.34-18.67 years) and the incidence of acute and chronic graft-versus-host disease, rejection, viral infections, EBV-lymphoproliferative disease, and survival was correlated with the ATG dose used. Cumulative doses from 7.5 to 20 mg/kg showed a constant half-life and linear correlation between dose and Cmax, whereas higher doses (30-40 mg/kg) accumulated in the body. High-dose ATG is of no benefit for preventing graft-versus-host disease but is associated with a significant increase in EBV-linked disease, and it appears to enhance the susceptibility to fatal viral infections and rejection. These data strongly support the use of a low-dose ATG regimen in pediatric HSCT.Keywords
This publication has 19 references indexed in Scilit:
- A prospective comparison of immune reconstitution in pediatric recipients of positively selected CD34+ peripheral blood stem cells from unrelated donors vs recipients of unmanipulated bone marrow from related donorsBone Marrow Transplantation, 2003
- Influence of Anti-Thymocyte Globulin As Part of the Conditioning Regimen on Immune Reconstitution Following Matched Related Bone Marrow TransplantationJournal of Hematotherapy & Stem Cell Research, 2003
- In Vivo T Cell Depletion with Low-Dose Rabbit Antithymocyte Globulin Results in Low Transplant-Related Mortality and Low Relapse Incidence Following Unrelated Hematopoietic Stem Cell TransplantationJournal of Hematotherapy & Stem Cell Research, 2002
- A humanized non–FcR-binding anti-CD3 antibody, visilizumab, for treatment of steroid-refractory acute graft-versus-host diseaseBlood, 2002
- Association between pretransplant Thymoglobulin and reduced non-relapse mortality rate after marrow transplantation from unrelated donorsBone Marrow Transplantation, 2002
- Comparison of horse antithymocyte globulin with other T cell-depleting antibodies for induction of chimerism and renal allograft tolerance in nonhuman primatesTransplantation Proceedings, 2001
- In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantationBlood, 2000
- Pediatric marrow transplantation for acute leukemia using unrelated donors and T-replete or -depleted grafts: a case-matched analysisBone Marrow Transplantation, 2000
- Children With Acute Lymphoblastic Leukemia Who Receive T-Cell–Depleted HLA Mismatched Marrow Allografts From Unrelated Donors Have an Increased Incidence of Primary Graft Failure but a Similar Overall Transplant OutcomeBlood, 1999
- Effect on cytokine release and graft-versus-host disease of different anti-T cell antibodies during conditioning for unrelated haematopoietic stem cell transplantationBone Marrow Transplantation, 1999