title: Anti-thymocyte globulin for conditioning in matched unrelated donor hematopoietic cell transplantation provides comparable outcomes to matched related donor recipients.
abstract: Rabbit anti-thymocyte globulin (ATG) is used as prophylaxis against GVHD following allogeneic hematopoietic cell transplantation (HCT). At our institution, ATG is exclusively used in the conditioning of matched unrelated donor (URD) transplant recipients. A total of 50 URD HCT recipients who received ATG (ATG group) were retrospectively compared with 48 matched related donor (MRD) HCT recipients who did not receive ATG (no ATG group). There were no significant differences between the groups in rates of day 100 mortality, acute GVHD or relapse. Chronic GVHD incidence was significantly lower in the ATG group (P = 0.007). At a median follow-up of 36 months in the entire cohort, 50% patients are alive in the ATG group and 63% of the patients are alive in the no ATG group (P = 0.13). We conclude that the administration of ATG to patients undergoing URD HCT preserves the anti-leukemia benefit of the transplant, while reducing the risk of developing GVHD, resulting in OS rates that are comparable to MRD HCT recipients.
authors.affiliation: Bone Marrow Transplant Program, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Portier
authors.forename: R T
authors.initials: RT
authors.lastname: Sabo
authors.forename: C H
authors.initials: CH
authors.lastname: Roberts
authors.forename: D S
authors.initials: DS
authors.lastname: Fletcher
authors.forename: J
authors.initials: J
authors.lastname: Meier
authors.forename: W B
authors.initials: WB
authors.lastname: Clark
authors.forename: M C
authors.initials: MC
authors.lastname: Neale
authors.forename: M H
authors.initials: MH
authors.lastname: Manjili
authors.forename: J M
authors.initials: JM
authors.lastname: McCarty
authors.forename: H M
authors.initials: HM
authors.lastname: Chung
authors.forename: A A
authors.initials: AA
authors.lastname: Toor
mesh_terms: D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000601:surgery; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors
chemical_list: D000961:Antilymphocyte Serum