ArticleClinical pharmacokinetics2015
Population pharmacokinetic modeling of Thymoglobulin(®) in children receiving allogeneic-hematopoietic cell transplantation: towards improved survival through individualized dosing.
Article in Clinical pharmacokinetics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 99 citations in OpenAlex.
- Pharmacokinetics and Pharmacodynamics of Systemic Corticosteroids in Autoimmune and Inflammatory Diseases: A Review of Current Evidence.Clinical pharmacokinetics · 2024Pooled it
- Refining busulfan exposure enhances pediatric ALL HSCT outcomes: insights from the International FORUM study.Blood advances · 2026Trial
- Improved survival with model-based dosing of antithymocyte globulin in pediatric hematopoietic cell transplantation.Blood advances · 2025Trial
- Standard Antithymocyte Globulin Dosing Results in Poorer Outcomes in Overexposed Patients after Ex Vivo CD34Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2019Trial
- Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome.Bone marrow transplantation · 2017Trial
- ATG exposure in T replete transplant for hematological malignancies: Real world analysis from BMT CTN 1202.Bone marrow transplantation · 2026Article
- Selective lymphodepletion underlies the efficacy of horse anti-thymocyte globulin-based immunosuppressive therapy in aplastic anemia.Haematologica · 2026Article
- Evaluation of Current and Novel Dosing Strategies for Anti-Thymocyte Globulin in Adult Allogeneic Hematopoietic Stem Cell Transplantation.CPT: pharmacometrics & systems pharmacology · 2026Article
- Usage of rabbit anti-thymocyte / anti-T-lymphocyte globulins (ATG / ATLG) for hematological malignancies in allogeneic hematopoietic cell transplantation: Best practice recommendations from the EBMT Practice Harmonisation and Guidelines Committee.Bone marrow transplantation · 2026Review
- Irradiation- and busulfan-free stem cell transplantation in Fanconi anemia using an anti-CD117 antibody: a phase 1b trial.Nature medicine · 2025Article
- Bodyweight and Absolute Lymphocyte Count-Based Dosing of Rabbit Anti-thymocyte Globulin Results in Early CD4Transplantation and cellular therapy · 2025Article
- Global research on the utilization of population pharmacokinetic model: a bibliometric analysis from 2000 to 2024.Frontiers in pharmacology · 2025Review
- Low-dose ATG/PTCy for graft-versus-host disease prevention in haploidentical transplantation: a single-center experience.Frontiers in oncology · 2025Article
- Optimizing anti-thymocyte globulin dosing in allogeneic hematopoietic stem cell transplantation: individualized approaches and clinical implications.Frontiers in immunology · 2025Review
- The relation between inflammatory biomarkers and drug pharmacokinetics in the critically ill patients: a scoping review.Critical care (London, England) · 2024Article
- Anti-T-lymphocyte globulin exposure is associated with acute graft-Haematologica · 2024Article
- Effect of clofarabine and fludarabine exposure on outcome after pediatric allogeneic hematopoietic cell transplantation.Blood neoplasia · 2024Article
- Model-Based Antithymocyte Globulin in αβhaplo-Hematopoietic Stem Cell Transplantation Facilitates Engraftment, Expedites T Cell Recovery, and Mitigates the Risk of Acute Graft-versus-Host Disease.Transplantation and cellular therapy · 2024Article
- Article
- Recent results of hematopoietic stem cell transplantation for thalassemia with busulfan-based conditioning regimen in France: improved thalassemia free survival despite frequent mixed chimerism. A retrospective study from the Francophone Society of Stem Cell Transplantation and Cellular Therapy (SFGM-TC).Bone marrow transplantation · 2023Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTo prevent graft-versus-host disease and rejection in hematopoietic cell transplantation (HCT), children receive Thymoglobulin(®), a polyclonal antibody acting mainly by depleting T cells. The therapeutic window is critical as over-exposure may result in delayed immune reconstitution of donor T cells. In this study, we describe the population pharmacokinetics of Thymoglobulin(®) as a first step towards an evidence-based dosing regimen of Thymoglobulin(®) in pediatric HCT.
methodsSerum active Thymoglobulin(®) concentrations were measured in all pediatric HCTs performed between 2004 and 2012 in two pediatric HCT centers in The Netherlands. Population pharmacokinetic analysis was performed using NONMEM(®) version 7.2.
resultsA total of 3,113 concentration samples from 280 pediatric HCTs were analyzed, with age ranging from 3 months to 23 years old. The cumulative Thymoglobulin(®) dose was 10 mg/kg in 94 % of the patients given in 4 consecutive days. A model incorporating parallel linear and concentration-dependent clearance of Thymoglobulin(®) was identified. Body weight [for linear clearance (CL) and central volume of distribution] as well as lymphocyte count pre-Thymoglobulin(®) infusion (for CL) were important covariates. As such, the current dosing regimen results in higher exposure in children with a higher bodyweight and/or a lower lymphocyte count pre-Thymoglobulin(®) infusion.
conclusionThis model can be used to develop an individual dosing regimen for Thymoglobulin(®), based on both body weight and lymphocyte counts, once the therapeutic window has been determined. This individualized regimen may contribute to a better immune reconstitution and thus outcome of allogeneic HCT.
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