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3. Immune reconstitution after haematopoietic transplantation with two different doses of pre-graft antithymocyte globulin

Author

P Rohrlich, Béatrice Pédron, Faezeh Legrand, Ghislaine Sterkers, Etienne Vilmer, P Bensaid, A Faye, Michel Duval, Larchee R, and B Lescoeur

Subjects
Male, Adolescent, Globulin, animal diseases, Graft vs Host Disease, chemical and pharmacologic phenomena, Opportunistic Infections, Immune system, Antigens, CD, Unrelated Donor, Immunopathology, medicine, Humans, Transplantation, Homologous, Child, Antilymphocyte Serum, Retrospective Studies, Transplantation, Dose-Response Relationship, Drug, biology, business.industry, Graft Survival, Hematopoietic Stem Cell Transplantation, Infant, Hematology, biochemical phenomena, metabolism, and nutrition, Kinetics, Haematopoiesis, surgical procedures, operative, medicine.anatomical_structure, Child, Preschool, Hematologic Neoplasms, Histocompatibility, Immune System, Immunology, biology.protein, Drug Evaluation, bacteria, Female, Bone marrow, Stem cell, business
Abstract

Antithymocyte globulin is widely used before haematopoietic transplantation with HLA-matched unrelated donors or mismatched relatives to prevent rejection and graft-versus-host disease (GVHD). However, optimal dosage is still under debate. Thirty-one consecutive children, mainly with haematological malignancies, were transplanted in a single institution with such donors, selected by HLA-A -B compatibility by serology and DRB1* by DNA typing. Antithymocyte globulin (Thymoglobuline; Sangstat) was infused at days -3, -2, -1. Total dosage varied: 16 patients received a median of 7.5 mg/kg (2.5 to 10.5: low-dose group), and 15 a median of 15.5 mg/kg (14.4 to 19.4: high-dose group). Post-transplant GVHD prophylaxis consisted of cyclosporine, short-course methotrexate and steroids. CD3(+), CD4(+) and CD19(+) cell reconstitution was slower in the high-dose group. Median time to reach 100 CD4(+) cells was 8 months vs 4 months (P = 0.03). Median time to normal CD19(+) cells was 16 months vs 8 months (P = 0.01). CD16(+)CD56(+) and CD8(+) cell reconstitution was similar. Nine patients in the high-dose group and two in the low-dose group experienced life-threatening opportunistic infections (P = 0.009). Although obtained from a limited number of patients, our data suggest that a higher pre-graft dose of antithymocyte globulin may negatively influence immune reconstitution.

Published
2002
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4. Conversion of HIV-1 viral markers during the first few months of life in HIV-infected children born to seropositive mothers

Author

Denamur E, Levine M, Simon F, Rohrlich P, Hélène Cavé, Rahimy C, de Crepy A, Boissinot C, Larchee R, and Lescoeur B

Subjects
Adult, Base Sequence, Molecular Sequence Data, HIV Core Protein p24, Infant, Newborn, Infant, HIV Infections, Polymerase Chain Reaction, Cohort Studies, Proviruses, Pregnancy, DNA, Viral, HIV-1, Leukocytes, Mononuclear, Humans, Female, Prospective Studies, Viremia, Pregnancy Complications, Infectious, Maternal-Fetal Exchange

6. Conversion of HIV-1 viral markers during the first few months of life in HIV-infected children born to seropositive mothers.

Author

Denamur E, Levine M, Simon F, Rohrlich P, Cave H, Rahimy C, de Crepy A, Boissinot C, Larchee R, and Lescoeur B

Subjects
Adult, Base Sequence, Cohort Studies, Female, HIV Infections diagnosis, HIV Infections microbiology, HIV Infections transmission, HIV-1 immunology, Humans, Infant, Infant, Newborn, Leukocytes, Mononuclear microbiology, Maternal-Fetal Exchange, Molecular Sequence Data, Polymerase Chain Reaction, Pregnancy, Prospective Studies, Proviruses isolation & purification, Viremia microbiology, DNA, Viral blood, HIV Core Protein p24 blood, HIV Infections congenital, HIV-1 isolation & purification, Pregnancy Complications, Infectious, Viremia congenital
Published
1993

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