title: High serum level of antithymocyte globulin immediately before graft infusion is associated with a low likelihood of chronic, but not acute, graft-versus-host disease.
abstract: Rabbit antithymocyte globulin (ATG) is administered during transplant conditioning to decrease the risk of both acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD). Here we evaluated the relationship between the serum concentration of ATG (capable of binding to lymphocytes) immediately before graft infusion (day 0) or on day +7 or +28 post-transplantation and the development of aGVHD or cGVHD. We studied 180 patients whose conditioning included 4.5 mg/kg antithymocyte globulin (ATG; Thymoglobulin). For aGVHD, we found no association with ATG levels on day 0. Nevertheless, high day +7 and +28 ATG levels were associated with a low likelihood of aGVHD. For cGVHD, high ATG levels at all 3 time points (days 0, +7, and +28) were associated with a low likelihood of cGVHD. In conclusion, high-dose ATG administration at the time of graft infusion appears to inhibit the development of cGVHD, but not aGVHD; however, higher ATG levels on days +7 and +28 are associated with lower rates of both aGVHD and cGVHD.
authors.affiliation: University of Calgary, Alberta, Canada; University of Copenhagen, Denmark. Electronic address: dr.sumitchawla@gmail.com.
authors.forename: Sumit
authors.initials: S
authors.lastname: Chawla
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Poonam
authors.initials: P
authors.lastname: Dharmani-Khan
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Liu
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Prokopishyn
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Amlish Munir
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Cameron
authors.initials: C
authors.lastname: Griffiths
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Faisal M
authors.initials: FM
authors.lastname: Khan
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Stewart
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: James A
authors.initials: JA
authors.lastname: Russell
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Daly
authors.affiliation: University of Calgary, Alberta, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Storek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011817:Rabbits; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; C512542:thymoglobulin
keywords: Acute GVHD; Antithymocyte globulin; Chronic GVHD