Influence of antithymocyte globulin dose on outcome in cytomegalovirus-seropositive recipients of partially T cell-depleted stem cell grafts from matched-unrelated donors

Br J Haematol. 2003 May;121(3):473-6. doi: 10.1046/j.1365-2141.2003.04294.x.

Abstract

The adverse impact of positive-recipient Cytomegalovirus (CMV) serostatus on the outcome of matched-unrelated donor (MUD) grafts has been stressed. We evaluated whether CMV-seropositive MUD recipients transplanted after 1999 still showed inferior outcome compared with CMV-seronegative recipients. Two important changes in transplantation procedure were introduced in 1999: (1) reduction of antithymocyte globulin dose, (2) introduction of sequence-based typing of HLA-DRB1. Thirty-six patients received partial T cell-depleted grafts before 1999, and 44 after 1999. CMV-seropositive patients transplanted before 1999 showed a highly significant inferior outcome compared with seronegative recipients. In contrast, no difference in outcome was observed between the two groups of patients transplanted after 1999.

MeSH terms

  • Adolescent
  • Adult
  • Antilymphocyte Serum / administration & dosage*
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / physiology
  • Cytomegalovirus Infections / complications*
  • Ganciclovir / therapeutic use
  • Humans
  • Leukemia / immunology
  • Leukemia / surgery*
  • Leukemia / virology*
  • Lymphocyte Count
  • Middle Aged
  • Regression Analysis
  • Stem Cell Transplantation / methods*
  • Survival Rate
  • T-Lymphocytes / immunology
  • Transplantation, Homologous
  • Treatment Outcome
  • Virus Activation

Substances

  • Antilymphocyte Serum
  • Antiviral Agents
  • Ganciclovir