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Conditioning Regimens

Anti-thymocyte globulin for conditioning in matched unrelated donor hematopoietic cell transplantation provides comparable outcomes to matched related donor recipients

Bone Marrow Transplantation volume 47, pages 1513–1519 (2012)Cite this article

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Abstract

Rabbit anti-thymocyte globulin (ATG) is used as prophylaxis against GVHD following allogeneic hematopoietic cell transplantation (HCT). At our institution, ATG is exclusively used in the conditioning of matched unrelated donor (URD) transplant recipients. A total of 50 URD HCT recipients who received ATG (ATG group) were retrospectively compared with 48 matched related donor (MRD) HCT recipients who did not receive ATG (no ATG group). There were no significant differences between the groups in rates of day 100 mortality, acute GVHD or relapse. Chronic GVHD incidence was significantly lower in the ATG group (P=0.007). At a median follow-up of 36 months in the entire cohort, 50% patients are alive in the ATG group and 63% of the patients are alive in the no ATG group (P=0.13). We conclude that the administration of ATG to patients undergoing URD HCT preserves the anti-leukemia benefit of the transplant, while reducing the risk of developing GVHD, resulting in OS rates that are comparable to MRD HCT recipients.

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Acknowledgements

We acknowledge Ms Cheryl Jacocks-Terrell for her help in preparing the manuscript. We also acknowledge the invaluable contribution of the bone transplant program physician extenders, Mr Richard Edwards PA-C, Mr John Lamberta, Mrs Shahrzad Rabie and Mrs Veronica Buckovich, BMT coordinators Mrs Judith Davis, Angela Buskey, Dana Broadway and Katherine Candler and BMT nurses towards the care of the patients included in this study.

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Authors and Affiliations

  1. Department of Internal Medicine, Bone Marrow Transplant Program, Virginia Commonwealth University, Richmond, VA, USA

    D A Portier, C H Roberts, D S Fletcher, J Meier, J M McCarty, H M Chung & A A Toor

  2. Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA

    R T Sabo

  3. Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA

    W B Clark & M H Manjili

  4. Department of Psychiatry and Genetics, Virginia Commonwealth University, Richmond, VA, USA

    M C Neale

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  1. D A Portier
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  2. R T Sabo
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Correspondence to A A Toor.

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Dr Toor, Dr McCarty and Dr Manjili have received research support from Genzyme incorporated.

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Portier, D., Sabo, R., Roberts, C. et al. Anti-thymocyte globulin for conditioning in matched unrelated donor hematopoietic cell transplantation provides comparable outcomes to matched related donor recipients. Bone Marrow Transplant 47, 1513–1519 (2012). https://doi.org/10.1038/bmt.2012.81

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