title: Antithymocyte globulin in allogeneic hematopoietic cell transplantation: benefits and limitations.
abstract: Significant advances have been made in allogeneic hematopoietic cell transplantation by reducing toxicities and optimizing its efficacy. Antithymocyte globulin (ATG) is an important in vivo T-cell depletion strategy, which reduces the risk of graft-versus-host disease in HLA-matched or -mismatched donor allografting. ATG effectively targets alloreactive T cells at the expense of potentially increasing the risk of post-hematopoietic cell transplantation infections and delayed immune reconstitution. We summarize the targets, mechanisms, various preparations of ATG, the growing role of ATG in prevention of graft-versus-host disease in various transplant modalities as well as emerging data on pharmacokinetic modeling for individualized ATG dosing. Further research is needed to optimize the ATG administration while minimizing the toxicities.
authors.affiliation: Department of Blood & Marrow Transplantation, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, FOB-3, Tampa, FL 33612, USA.|Department of Oncologic Sciences, Morsani College of Medicine, Moffitt Cancer Center/University of South Florida, Tampa, FL, USA.
authors.forename: Taiga
authors.initials: T
authors.lastname: Nishihori
authors.affiliation: Emory University, Atlanta, GA, USA.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Al-Kadhimi
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
authors.affiliation: Department of Blood & Marrow Transplantation, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, FOB-3, Tampa, FL 33612, USA.|Department of Oncologic Sciences, Morsani College of Medicine, Moffitt Cancer Center/University of South Florida, Tampa, FL, USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Kharfan-Dabaja
mesh_terms: D000818:Animals; D000961:Antilymphocyte Serum / Q000276:immunology*; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000276:immunology*; D008212:Lymphocyte Depletion; D013601:T-Lymphocytes / Q000276:immunology*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents
keywords: ATG; GVHD; T-cell depletion; pharmacokinetics