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Seidel, MG; Fritsch, G; Matthes-Martin, S; Lawitschka, A; Lion, T; Pötschger, U; Rosenmayr, A; Fischer, G; Gadner, H; Peters, C.
Antithymocyte globulin pharmacokinetics in pediatric patients after hematopoietic stem cell transplantation.
J Pediatr Hematol Oncol. 2005; 27(10):532-536
Doi: 10.1097/01.mph.0000184575.00717.25
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
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Seidel Markus
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- Abstract:
- To analyze the dose effects of rabbit-derived antithymocyte globulin (ATG) in children after allogeneic hematopoietic stem cell transplantation (HSCT), ATG serum levels were monitored in 32 children and adolescents (median age 3.42 years, range 0.34-18.67 years) and the incidence of acute and chronic graft-versus-host disease, rejection, viral infections, EBV-lymphoproliferative disease, and survival was correlated with the ATG dose used. Cumulative doses from 7.5 to 20 mg/kg showed a constant half-life and linear correlation between dose and Cmax, whereas higher doses (30-40 mg/kg) accumulated in the body. High-dose ATG is of no benefit for preventing graft-versus-host disease but is associated with a significant increase in EBV-linked disease, and it appears to enhance the susceptibility to fatal viral infections and rejection. These data strongly support the use of a low-dose ATG regimen in pediatric HSCT.
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Adolescent -
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Animals -
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Antilymphocyte Serum - administration and dosage Antilymphocyte Serum - blood
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Child -
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Child, Preschool -
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Cyclosporine - pharmacology
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Dose-Response Relationship, Drug -
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Epstein-Barr Virus Infections - etiology Epstein-Barr Virus Infections - pathology
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Female -
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Graft Rejection - prevention and control
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Graft vs Host Disease - drug therapy
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Hematopoietic Stem Cell Transplantation -
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Herpesvirus 4, Human - isolation and purification
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Histocompatibility Testing -
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Humans -
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Immunosuppressive Agents - administration and dosage Immunosuppressive Agents - blood
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Incidence -
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Infant -
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Lymphoproliferative Disorders - etiology Lymphoproliferative Disorders - pathology
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Male -
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Rabbits -
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Retrospective Studies -
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Transplantation Conditioning -
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pediatric transplantation immunology
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in vivo T-cell depletion
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graft-versus-host disease prophylaxis
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rejection