PMID- 27905258 OWN - NLM STAT- MEDLINE DCOM- 20170406 LR - 20170406 IS - 1607-8454 (Electronic) IS - 1024-5332 (Linking) VI - 22 IP - 3 DP - 2017 Apr TI - HLA-mismatched haploidentical transplantation using low-dose anti-thymocyte globulin (ATG: thymoglobulin). PG - 129-135 LID - 10.1080/10245332.2016.1231968 [doi] AB - OBJECTIVES: To clarify optimal strategies for human leukocyte antigen (HLA)-mismatched haploidentical hematopoietic stem cell transplantation (HSCT). METHODS: Twelve patients who underwent HSCT from a haploidentical related donor using low-dose thymoglobulin were analyzed retrospectively. Thymoglobulin was added to conditioning regimens at 2.5 mg/kg/day for 2 days (days -4 and -3). Prophylaxis against graft-versus-host disease (GVHD) was performed with cyclosporine and methotrexate. RESULTS: The median age of the patients was 33 years. Six patients had previous allogeneic HSCT, and HSCT was performed in non-remission for nine patients. All patients but one, who died due to early infection, achieved neutrophil engraftment at a median of 17 days with complete donor-type chimerism. Acute and chronic GVHD were observed in six and five patients, respectively, but no patients died of GVHD-associated complication. No one developed cytomegalovirus disease, but Epstein-Barr virus-related lymphoproliferative disorder was observed in one patient. Long-term survival in remission without immunosuppressive agents are observed in two patients who underwent HSCT in remission, but the majority of patients who underwent HSCT in non-remission experienced disease progression. CONCLUSION: Haploidentical HSCT could be performed with thymoglobulin at 5 mg/kg, with the balance between GVHD and relapse rate. The dose reduction of thymoglobulin may be considered for advanced hematological malignancy. FAU - Kako, Shinichi AU - Kako S AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Akahoshi, Yu AU - Akahoshi Y AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Harada, Naonori AU - Harada N AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Nakano, Hirofumi AU - Nakano H AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kameda, Kazuaki AU - Kameda K AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Ugai, Tomotaka AU - Ugai T AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Yamasaki, Ryoko AU - Yamasaki R AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Wada, Hidenori AU - Wada H AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Ishihara, Yuko AU - Ishihara Y AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kawamura, Koji AU - Kawamura K AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Sakamoto, Kana AU - Sakamoto K AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Sato, Miki AU - Sato M AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Ashizawa, Masahiro AU - Ashizawa M AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Terasako-Saito, Kiriko AU - Terasako-Saito K AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kimura, Shun-Ichi AU - Kimura SI AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kikuchi, Misato AU - Kikuchi M AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Nakasone, Hideki AU - Nakasone H AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Yamazaki, Rie AU - Yamazaki R AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kanda, Junya AU - Kanda J AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. FAU - Kanda, Yoshinobu AU - Kanda Y AD - a Division of Hematology, Saitama Medical Center , Jichi Medical University , Saitama , Japan. LA - eng PT - Journal Article DEP - 20161201 PL - England TA - Hematology JT - Hematology (Amsterdam, Netherlands) JID - 9708388 RN - 0 (Antilymphocyte Serum) RN - 0 (HLA Antigens) RN - 0 (Immunosuppressive Agents) RN - D7RD81HE4W (thymoglobulin) SB - IM MH - Adolescent MH - Adult MH - Antilymphocyte Serum/*administration & dosage MH - Disease Progression MH - Female MH - Graft Survival MH - Graft vs Host Disease/etiology/prevention & control MH - HLA Antigens/*genetics/*immunology MH - *Haplotypes MH - Hematologic Neoplasms/complications/diagnosis/therapy MH - *Hematopoietic Stem Cell Transplantation/adverse effects MH - Humans MH - Immunosuppressive Agents/therapeutic use MH - Male MH - Middle Aged MH - Retrospective Studies MH - Transplantation Chimera MH - *Transplantation Conditioning/adverse effects/methods MH - Transplantation, Homologous MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - Thymoglobulin OT - allogeneic hematopoietic stem cell transplantation OT - haploidentical donor OT - immune reconstitution EDAT- 2016/12/03 06:00 MHDA- 2017/04/07 06:00 CRDT- 2016/12/02 06:00 PHST- 2016/12/03 06:00 [pubmed] PHST- 2017/04/07 06:00 [medline] PHST- 2016/12/02 06:00 [entrez] AID - 10.1080/10245332.2016.1231968 [doi] PST - ppublish SO - Hematology. 2017 Apr;22(3):129-135. doi: 10.1080/10245332.2016.1231968. Epub 2016 Dec 1.