Effect of ATG-F on B-cell reconstitution after hematopoietic stem cell transplantation

Eur J Haematol. 2015 Dec;95(6):514-23. doi: 10.1111/ejh.12524. Epub 2015 Mar 13.

Abstract

Antithymocyte globulin Fresenius (ATG-F) is used before hematopoietic stem cell transplantation to prevent graft rejection and graft-versus-host disease in patients with HLA-matched unrelated donors or mismatched volunteers. However, little is known about the effect of ATG-F on the reconstitution of B-cell subsets. Sixty-seven patients were longitudinally studied at day 15, day 30, and then monthly after hematopoietic stem cell transplantation. Conditioning regimes included ATG-F, which was infused at days 3, 2 and 1 at a dosage of 10 mg/kg/d. Twenty-seven patients received conditioning regimes without ATG. ATG-treated patients showed a significant delay of CD19+ B cells in the early recovery period. The absolute numbers of circulating CD19+ B cells were significantly lower (P < 0.05) up to 5 months post-transplantation compared to non-ATG patients. The recovery of the memory compartment was delayed in both groups and did not reach normal values 1-year post-transplantation. ATG-treated patient showed significantly lower absolute numbers of circulating CD27+ memory B cells in the first-month after transplantation compared to non-ATG patients. In conclusion, treatment with ATG in the conditioning regime of patients undergoing allogeneic hematopoietic stem cell transplantation leads to a significant delay of CD19+ B cells. Thus, ATG seems also to negatively influence B-cell immune reconstitution.

Keywords: ATG; B cells; Stem cell transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Surface / metabolism
  • Antilymphocyte Serum / pharmacology
  • Antilymphocyte Serum / therapeutic use*
  • B-Lymphocyte Subsets / drug effects
  • B-Lymphocyte Subsets / physiology
  • B-Lymphocytes / drug effects*
  • B-Lymphocytes / physiology*
  • Female
  • Graft Rejection / drug therapy
  • Graft Survival
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Immunoglobulin Class Switching
  • Immunologic Memory
  • Immunophenotyping
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Phenotype
  • Somatic Hypermutation, Immunoglobulin
  • Time Factors
  • Tissue Donors
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Antigens, Surface
  • Antilymphocyte Serum
  • Immunosuppressive Agents