Impact of low-dose anti-thymocyte globulin on immune reconstitution after allogeneic hematopoietic cell transplantation

Ayumu Ito, Shigehisa Kitano, Kinuko Tajima, Youngji Kim, Takashi Tanaka, Yoshihiro Inamoto, Sung Won Kim, Noboru Yamamoto, Takahiro Fukuda, Shinichiro Okamoto

Research output: Contribution to journalArticle

Abstract

How low-dose anti-thymocyte globulin (ATG) for prophylaxis of graft-versus-host disease (GVHD) influences immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HCT) remains incompletely understood. We prospectively enrolled 41 consecutive adult patients and conducted cytometry-based immunophenotyping for 12 months after allo-HCT. Rabbit ATG (Thymoglobulin) was administered at a median total dose of 1.75 mg/kg in 16 of the 41 patients. Compared with patients who did not receive ATG, those who did had a significantly smaller number of naïve T cells (especially CD4+) within three months after allo-HCT. No significant difference was observed between the two groups in the reconstitution of other T cells (effector, memory, Th1, Th2, Th17, Treg, and Tfh), B cells (transitional, naïve, memory, and plasmablast), NK cells (regulatory and cytolytic), or dendritic cells (myeloid and plasmacytoid). Patients with fewer CD4+ naïve T cells than the median count (7.60 cells/µL) at two months after allo-HCT developed chronic GVHD less frequently than those with CD4+ naïve T cells above the median count (2-year cumulative incidences were 0.31 and 0.53, respectively; p = 0.133). This pilot study suggests low-dose Thymoglobulin suppresses the recovery of naïve T cells after allo-HCT, which may contribute to a lower incidence of chronic GVHD.

Original languageEnglish
JournalInternational journal of hematology
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Fingerprint

Antilymphocyte Serum
Hematopoietic Stem Cell Transplantation
Cell Transplantation
T-Lymphocytes
Graft vs Host Disease
Immunophenotyping
B-Lymphoid Precursor Cells
Incidence
Natural Killer Cells
Dendritic Cells
Cell Count
Rabbits

Keywords

  • Allogeneic hematopoietic stem cell transplantation (allo-HCT)
  • Anti-thymocyte globulin (ATG)
  • Graft-versus-host disease (GVHD)
  • Immune reconstitution

ASJC Scopus subject areas

  • Hematology

Cite this

Impact of low-dose anti-thymocyte globulin on immune reconstitution after allogeneic hematopoietic cell transplantation. / Ito, Ayumu; Kitano, Shigehisa; Tajima, Kinuko; Kim, Youngji; Tanaka, Takashi; Inamoto, Yoshihiro; Kim, Sung Won; Yamamoto, Noboru; Fukuda, Takahiro; Okamoto, Shinichiro.

In: International journal of hematology, 01.01.2019.

Research output: Contribution to journalArticle

Ito, Ayumu ; Kitano, Shigehisa ; Tajima, Kinuko ; Kim, Youngji ; Tanaka, Takashi ; Inamoto, Yoshihiro ; Kim, Sung Won ; Yamamoto, Noboru ; Fukuda, Takahiro ; Okamoto, Shinichiro. / Impact of low-dose anti-thymocyte globulin on immune reconstitution after allogeneic hematopoietic cell transplantation. In: International journal of hematology. 2019.
@article{2c86281b52e64606838b9e80eb901787,
title = "Impact of low-dose anti-thymocyte globulin on immune reconstitution after allogeneic hematopoietic cell transplantation",
abstract = "How low-dose anti-thymocyte globulin (ATG) for prophylaxis of graft-versus-host disease (GVHD) influences immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HCT) remains incompletely understood. We prospectively enrolled 41 consecutive adult patients and conducted cytometry-based immunophenotyping for 12 months after allo-HCT. Rabbit ATG (Thymoglobulin) was administered at a median total dose of 1.75 mg/kg in 16 of the 41 patients. Compared with patients who did not receive ATG, those who did had a significantly smaller number of na{\"i}ve T cells (especially CD4+) within three months after allo-HCT. No significant difference was observed between the two groups in the reconstitution of other T cells (effector, memory, Th1, Th2, Th17, Treg, and Tfh), B cells (transitional, na{\"i}ve, memory, and plasmablast), NK cells (regulatory and cytolytic), or dendritic cells (myeloid and plasmacytoid). Patients with fewer CD4+ na{\"i}ve T cells than the median count (7.60 cells/µL) at two months after allo-HCT developed chronic GVHD less frequently than those with CD4+ na{\"i}ve T cells above the median count (2-year cumulative incidences were 0.31 and 0.53, respectively; p = 0.133). This pilot study suggests low-dose Thymoglobulin suppresses the recovery of na{\"i}ve T cells after allo-HCT, which may contribute to a lower incidence of chronic GVHD.",
keywords = "Allogeneic hematopoietic stem cell transplantation (allo-HCT), Anti-thymocyte globulin (ATG), Graft-versus-host disease (GVHD), Immune reconstitution",
author = "Ayumu Ito and Shigehisa Kitano and Kinuko Tajima and Youngji Kim and Takashi Tanaka and Yoshihiro Inamoto and Kim, {Sung Won} and Noboru Yamamoto and Takahiro Fukuda and Shinichiro Okamoto",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s12185-019-02756-1",
language = "English",
journal = "International Journal of Hematology",
issn = "0925-5710",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Impact of low-dose anti-thymocyte globulin on immune reconstitution after allogeneic hematopoietic cell transplantation

AU - Ito, Ayumu

AU - Kitano, Shigehisa

AU - Tajima, Kinuko

AU - Kim, Youngji

AU - Tanaka, Takashi

AU - Inamoto, Yoshihiro

AU - Kim, Sung Won

AU - Yamamoto, Noboru

AU - Fukuda, Takahiro

AU - Okamoto, Shinichiro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - How low-dose anti-thymocyte globulin (ATG) for prophylaxis of graft-versus-host disease (GVHD) influences immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HCT) remains incompletely understood. We prospectively enrolled 41 consecutive adult patients and conducted cytometry-based immunophenotyping for 12 months after allo-HCT. Rabbit ATG (Thymoglobulin) was administered at a median total dose of 1.75 mg/kg in 16 of the 41 patients. Compared with patients who did not receive ATG, those who did had a significantly smaller number of naïve T cells (especially CD4+) within three months after allo-HCT. No significant difference was observed between the two groups in the reconstitution of other T cells (effector, memory, Th1, Th2, Th17, Treg, and Tfh), B cells (transitional, naïve, memory, and plasmablast), NK cells (regulatory and cytolytic), or dendritic cells (myeloid and plasmacytoid). Patients with fewer CD4+ naïve T cells than the median count (7.60 cells/µL) at two months after allo-HCT developed chronic GVHD less frequently than those with CD4+ naïve T cells above the median count (2-year cumulative incidences were 0.31 and 0.53, respectively; p = 0.133). This pilot study suggests low-dose Thymoglobulin suppresses the recovery of naïve T cells after allo-HCT, which may contribute to a lower incidence of chronic GVHD.

AB - How low-dose anti-thymocyte globulin (ATG) for prophylaxis of graft-versus-host disease (GVHD) influences immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HCT) remains incompletely understood. We prospectively enrolled 41 consecutive adult patients and conducted cytometry-based immunophenotyping for 12 months after allo-HCT. Rabbit ATG (Thymoglobulin) was administered at a median total dose of 1.75 mg/kg in 16 of the 41 patients. Compared with patients who did not receive ATG, those who did had a significantly smaller number of naïve T cells (especially CD4+) within three months after allo-HCT. No significant difference was observed between the two groups in the reconstitution of other T cells (effector, memory, Th1, Th2, Th17, Treg, and Tfh), B cells (transitional, naïve, memory, and plasmablast), NK cells (regulatory and cytolytic), or dendritic cells (myeloid and plasmacytoid). Patients with fewer CD4+ naïve T cells than the median count (7.60 cells/µL) at two months after allo-HCT developed chronic GVHD less frequently than those with CD4+ naïve T cells above the median count (2-year cumulative incidences were 0.31 and 0.53, respectively; p = 0.133). This pilot study suggests low-dose Thymoglobulin suppresses the recovery of naïve T cells after allo-HCT, which may contribute to a lower incidence of chronic GVHD.

KW - Allogeneic hematopoietic stem cell transplantation (allo-HCT)

KW - Anti-thymocyte globulin (ATG)

KW - Graft-versus-host disease (GVHD)

KW - Immune reconstitution

UR - http://www.scopus.com/inward/record.url?scp=85074039574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074039574&partnerID=8YFLogxK

U2 - 10.1007/s12185-019-02756-1

DO - 10.1007/s12185-019-02756-1

M3 - Article

C2 - 31641956

AN - SCOPUS:85074039574

JO - International Journal of Hematology

JF - International Journal of Hematology

SN - 0925-5710

ER -