title: The effect of equine antithymocyte globulin on the outcomes of reduced intensity conditioning for AML.
abstract: Whether or not the benefits of antithymocyte globulin (ATG) on engraftment and GVHD are offset by increased risk of relapse, delayed T-cell recovery and increased infections remains controversial. We retrospectively studied the effect of ATG in 144 AML patients, 34 of whom received ATG, undergoing reduced intensity conditioning (RIC) umbilical cord blood transplantation (UCB) or HLA-matched sibling PBSC. ATG patients had not received intensive chemotherapy for 3 months before transplantation for UCB, 6 months for PBSC. There were no differences in engraftment between ATG and non-ATG patients. The cumulative incidences of TRM as well as acute and chronic GVHD in ATG-treated patients were not statistically different. ATG patients had significantly more infections between 46 and 180 days post transplantation. Unexpectedly, after adjusting for donor type, relapse was lower among ATG recipients (relative risk (RR) 0.5, 95% confidence interval (CI) 0.3-1.0, P=0.04). In summary, administration of ATG to AML patients undergoing RIC had no adverse impact on major clinical outcomes. ATG may be indicated for patients at higher risk of graft failure after allogeneic hematopoietic cell transplantation (allo-HCT).
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: P
authors.initials: P
authors.lastname: Hagen
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Wagner
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: DeFor
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Dolan
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Arora
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: E
authors.initials: E
authors.lastname: Warlick
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: D
authors.initials: D
authors.lastname: Weisdorf
authors.affiliation: Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Brunstein
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D005260:Female; D006086:Graft vs Host Disease; D006680:HLA Antigens / Q000737:chemistry; D018380:Hematopoietic Stem Cell Transplantation; D006736:Horses; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D000970:Antineoplastic Agents; D006680:HLA Antigens