title: Anti-thymocyte globulin as graft-versus-host disease prevention in the setting of allogeneic peripheral blood stem cell transplantation: a review from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
abstract: Allogeneic hematopoietic stem cell transplantation is increasingly used as treatment for patients with life-threatening blood diseases. Its curative potential is largely based on immune-mediated graft-versus-leukemia effects caused by donor T cells contained in the graft. Unfortunately, donor T cells are also the cause of graft-versus-host disease. The vast majority of human leukocyte antigen-matched allogeneic hematopoietic stem cell transplants are nowadays carried out with peripheral blood stem cells as the stem cell source. In comparison with bone marrows, peripheral blood stem cells contain more hematopoietic stem/progenitor cells but also one log more T cells. Consequently, the use of peripheral blood stem cells instead of bone marrow has been associated with faster hematologic recovery and a lower risk of relapse in patients with advanced disease, but also with a higher incidence of chronic graft-versus-host disease. These observations have been the basis for several studies aimed at assessing the impact of immunoregulation with anti-thymocyte globulin on transplantation outcomes in patients given human leukocyte antigen-matched peripheral blood stem cells from related or unrelated donors. After a brief introduction on anti-thymocyte globulin, this article reviews recent studies assessing the impact of anti-thymocyte globulin on transplantation outcomes in patients given peripheral blood stem cells from human leukocyte antigen-matched related or unrelated donors as well as in recipients of grafts from human leukocyte antigen haploidentical donors.
authors.affiliation: Giga-Hematology University of Liège, Belgium f.baron@ulg.ac.be.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Baron
authors.affiliation: Hopital Saint-Antoine, AP-HP, Paris, France.|Université Pierre & Marie Curie, Paris, France.|INSERM UMRs U938, Paris, France.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Aix Marseille Univ, CNRS, INSERM, CRCM, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.affiliation: AP-HP, Hematology Transplantation, Hospital Saint-Louis, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Socié
authors.affiliation: Hopital Saint-Antoine, AP-HP, Paris, France.|INSERM UMRs U938, Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Department of Hematology, Hospital Clinic, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.affiliation: Department of Hematology, Ospedale San Raffaele, Università degli Studi, Milano, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: Maria Sklodowska-Curie Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
authors.affiliation: Hopital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Norbert Claude
authors.initials: NC
authors.lastname: Gorin
authors.affiliation: Long term Transplant Clinic, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Klinikum Augsburg, Department of Hematology and Oncology, University of Munich, Augsburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
authors.affiliation: Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.|EBMT Paris Office, Hospital Saint Antoine, Paris, France.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
mesh_terms: D000818:Animals; D000961:Antilymphocyte Serum / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006086:Graft vs Host Disease / Q000209:etiology* / Q000517:prevention & control*; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006239:Haplotypes; D006412:Hematopoietic Stem Cells / Q000276:immunology / Q000378:metabolism; D006801:Humans; D056747:Immunomodulation / Q000187:drug effects / Q000276:immunology; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011817:Rabbits; D035781:Siblings; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors
chemical_list: D000961:Antilymphocyte Serum; D006680:HLA Antigens; D007166:Immunosuppressive Agents