Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation
Anti-thymocyte globulin (ATG) is a lymphocyte depleting agent applied in hematopoietic stem cell transplantation (HSCT) to prevent rejection and Graft-vs.-Host Disease (GvHD). In this study, we compared two rabbit ATG products, ATG-Genzyme (ATG-GENZ), and ATG-Fresenius (ATG-FRES), with respect to do...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2019-03-01
|
Series: | Frontiers in Immunology |
Subjects: | |
Online Access: | https://www.frontiersin.org/article/10.3389/fimmu.2019.00315/full |
id |
doaj-8044e135e7df45b3a36d392be8be61d7 |
---|---|
record_format |
Article |
spelling |
doaj-8044e135e7df45b3a36d392be8be61d72020-11-25T02:18:36ZengFrontiers Media S.A.Frontiers in Immunology1664-32242019-03-011010.3389/fimmu.2019.00315435886Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell TransplantationLisa V. E. Oostenbrink0Cornelia M. Jol-van der Zijde1Katrine Kielsen2Katrine Kielsen3Anja M. Jansen-Hoogendijk4Marianne Ifversen5Klaus G. Müller6Klaus G. Müller7Arjan C. Lankester8Astrid G. S. van Halteren9Robbert G. M. Bredius10Marco W. Schilham11Maarten J. D. van Tol12Department of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsInstitute for Inflammation Research, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkInstitute for Inflammation Research, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pediatrics, Leiden University Medical Center, Leiden, NetherlandsAnti-thymocyte globulin (ATG) is a lymphocyte depleting agent applied in hematopoietic stem cell transplantation (HSCT) to prevent rejection and Graft-vs.-Host Disease (GvHD). In this study, we compared two rabbit ATG products, ATG-Genzyme (ATG-GENZ), and ATG-Fresenius (ATG-FRES), with respect to dosing, clearance of the active lymphocyte binding component, post-HSCT immune reconstitution and clinical outcome. Fifty-eigth pediatric acute leukemia patients (n = 42 ATG-GENZ, n = 16 ATG-FRES), who received a non-depleted bone marrow or peripheral blood stem cell graft from an unrelated donor were included. ATG-GENZ was given at a dosage of 6–10 mg/kg; ATG-FRES at 45–60 mg/kg. The active component of ATG from both products was cleared at different rates. Within the ATG-FRES dose range no differences were found in clearance of active ATG or T-cell re-appearance. However, the high dosage of ATG-GENZ (10 mg/kg), in contrast to the low dosage (6–8 mg/kg), correlated with prolonged persistence of active ATG and delayed T-cell reconstitution. Occurrence of serious acute GvHD (grade III–IV) was highest in the ATG-GENZ-low dosage group. These results imply that dosing of ATG-GENZ is more critical than dosing of ATG-FRES due to the difference in clearance of active ATG. This should be taken into account when designing clinical protocols.https://www.frontiersin.org/article/10.3389/fimmu.2019.00315/fullATGGenzymeFreseniusserotherapypediatricsacute GvHD |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lisa V. E. Oostenbrink Cornelia M. Jol-van der Zijde Katrine Kielsen Katrine Kielsen Anja M. Jansen-Hoogendijk Marianne Ifversen Klaus G. Müller Klaus G. Müller Arjan C. Lankester Astrid G. S. van Halteren Robbert G. M. Bredius Marco W. Schilham Maarten J. D. van Tol |
spellingShingle |
Lisa V. E. Oostenbrink Cornelia M. Jol-van der Zijde Katrine Kielsen Katrine Kielsen Anja M. Jansen-Hoogendijk Marianne Ifversen Klaus G. Müller Klaus G. Müller Arjan C. Lankester Astrid G. S. van Halteren Robbert G. M. Bredius Marco W. Schilham Maarten J. D. van Tol Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation Frontiers in Immunology ATG Genzyme Fresenius serotherapy pediatrics acute GvHD |
author_facet |
Lisa V. E. Oostenbrink Cornelia M. Jol-van der Zijde Katrine Kielsen Katrine Kielsen Anja M. Jansen-Hoogendijk Marianne Ifversen Klaus G. Müller Klaus G. Müller Arjan C. Lankester Astrid G. S. van Halteren Robbert G. M. Bredius Marco W. Schilham Maarten J. D. van Tol |
author_sort |
Lisa V. E. Oostenbrink |
title |
Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation |
title_short |
Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation |
title_full |
Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation |
title_fullStr |
Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation |
title_full_unstemmed |
Differential Elimination of Anti-Thymocyte Globulin of Fresenius and Genzyme Impacts T-Cell Reconstitution After Hematopoietic Stem Cell Transplantation |
title_sort |
differential elimination of anti-thymocyte globulin of fresenius and genzyme impacts t-cell reconstitution after hematopoietic stem cell transplantation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2019-03-01 |
description |
Anti-thymocyte globulin (ATG) is a lymphocyte depleting agent applied in hematopoietic stem cell transplantation (HSCT) to prevent rejection and Graft-vs.-Host Disease (GvHD). In this study, we compared two rabbit ATG products, ATG-Genzyme (ATG-GENZ), and ATG-Fresenius (ATG-FRES), with respect to dosing, clearance of the active lymphocyte binding component, post-HSCT immune reconstitution and clinical outcome. Fifty-eigth pediatric acute leukemia patients (n = 42 ATG-GENZ, n = 16 ATG-FRES), who received a non-depleted bone marrow or peripheral blood stem cell graft from an unrelated donor were included. ATG-GENZ was given at a dosage of 6–10 mg/kg; ATG-FRES at 45–60 mg/kg. The active component of ATG from both products was cleared at different rates. Within the ATG-FRES dose range no differences were found in clearance of active ATG or T-cell re-appearance. However, the high dosage of ATG-GENZ (10 mg/kg), in contrast to the low dosage (6–8 mg/kg), correlated with prolonged persistence of active ATG and delayed T-cell reconstitution. Occurrence of serious acute GvHD (grade III–IV) was highest in the ATG-GENZ-low dosage group. These results imply that dosing of ATG-GENZ is more critical than dosing of ATG-FRES due to the difference in clearance of active ATG. This should be taken into account when designing clinical protocols. |
topic |
ATG Genzyme Fresenius serotherapy pediatrics acute GvHD |
url |
https://www.frontiersin.org/article/10.3389/fimmu.2019.00315/full |
work_keys_str_mv |
AT lisaveoostenbrink differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT corneliamjolvanderzijde differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT katrinekielsen differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT katrinekielsen differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT anjamjansenhoogendijk differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT marianneifversen differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT klausgmuller differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT klausgmuller differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT arjanclankester differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT astridgsvanhalteren differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT robbertgmbredius differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT marcowschilham differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation AT maartenjdvantol differentialeliminationofantithymocyteglobulinoffreseniusandgenzymeimpactstcellreconstitutionafterhematopoieticstemcelltransplantation |
_version_ |
1724881021519790080 |