title: Lower dose of antithymocyte globulin does not increase graft-versus-host disease in patients undergoing reduced-intensity conditioning allogeneic hematopoietic stem cell transplant.
abstract: The appropriate dose of antithymocyte globulin (ATG) to be utilized in reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplant (alloHSCT) is as yet unknown. We retrospectively compared patients who received 7.5 mg/kg (R-ATG, 39 patients) and 6 mg/kg (r-ATG, 97 patients). The cumulative incidences of acute graft-versus-host disease (aGVHD) grade II-IV at 180 days were 46% and 41% and of aGVHD grade III-IV were 11% and 18% in r-ATG and R-ATG, respectively (p > 0.30). The respective estimated cumulative incidences at 24 months of cGVHD were 42% and 44% (p > 0.30). There was no significant difference in non-relapse mortality (p = 0.22), cumulative incidence of relapse (p = 0.53), progression-free survival (p = 0.69) or overall survival (p = 0.95). In conclusion, a decreased ATG dose of 6 mg/kg was associated with a similar proportion of GVHD to 7.5 mg/kg ATG. Given the increasing number of RIC HSCTs performed worldwide, the correct dose and preparation of ATG should be defined by prospective randomized trials.
authors.affiliation: Division of Hematology, Department of Internal Medicine, The Ohio State University , Columbus, OH , USA.
authors.forename: Galena
authors.initials: G
authors.lastname: Salem
authors.forename: Amy S
authors.initials: AS
authors.lastname: Ruppert
authors.forename: Patrick
authors.initials: P
authors.lastname: Elder
authors.forename: Craig C
authors.initials: CC
authors.lastname: Hofmeister
authors.forename: Don M
authors.initials: DM
authors.lastname: Benson
authors.forename: Sam
authors.initials: S
authors.lastname: Penza
authors.forename: Leslie
authors.initials: L
authors.lastname: Andritsos
authors.forename: Rebecca
authors.initials: R
authors.lastname: Klisovic
authors.forename: Sumithira
authors.initials: S
authors.lastname: Vasu
authors.forename: William
authors.initials: W
authors.lastname: Blum
authors.forename: Steven M
authors.initials: SM
authors.lastname: Devine
authors.forename: Samantha
authors.initials: S
authors.lastname: Jaglowski
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Efebera
mesh_terms: D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002066:Busulfan / Q000627:therapeutic use; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D014740:Vidarabine; D002066:Busulfan
keywords: Antithymocyte globulin; allogeneic transplant; reduced-intensity conditioning