The putative anti-leukemic effects of anti-thymocyte globulins in patients with CD7-positive acute myeloid leukemia

Bone Marrow Transplant. 2018 Aug;53(8):1019-1029. doi: 10.1038/s41409-018-0115-7. Epub 2018 Feb 19.

Abstract

Polyclonal anti-thymocyte globulins (ATGs) are widely used in allogeneic stem cell transplantation (allo-SCT) for GvHD prophylaxis. ATGs exerted anti-tumor effects in in vitro experiments, but in vivo studies are lacking. We experienced a case of relapsed AML with cells positive for CD7 who underwent haploidentical SCT and unexpectedly achieved a significant reduction of AML cells in the peripheral blood after receiving ATGs before the administration of other drugs in the conditioning regimen. This patient achieved long-term survival after haploidentical SCT. To assess the impact of ATGs on clinical outcomes in patients with AML, we performed a retrospective analysis of allo-SCT for relapsed/refractory AML and divided 132 patients into four groups according to the expression of CD7 in AML cells and use of ATGs as part of the conditioning regimen, as follows: CD7-positive ATG group (n = 15), CD7-positive no-ATG group (n = 32), CD7-negative ATG group (n = 19), and CD7-negative no-ATG group (n = 66). The overall survival rates in the CD7-positive ATG group were significantly higher than those in the CD7-positive no-ATG group, whereas these rates did not differ statistically between the CD7-negative ATG and CD7-negative no-ATG groups. Our results indicate a possible anti-leukemic effect of ATGs against CD7-positive AML in humans.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antilymphocyte Serum / pharmacology
  • Antilymphocyte Serum / therapeutic use*
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / pathology
  • Male
  • Middle Aged
  • Survival Rate

Substances

  • Antilymphocyte Serum