The gvhd Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the gvhd Hub cannot guarantee the accuracy of translated content. The gvhd and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The GvHD Hub is an independent medical education platform, sponsored by Medac and supported through grants from Sanofi and Therakos. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.
Now you can support HCPs in making informed decisions for their patients
Your contribution helps us continuously deliver expertly curated content to HCPs worldwide. You will also have the opportunity to make a content suggestion for consideration and receive updates on the impact contributions are making to our content.
Find out more
Create an account and access these new features:
Bookmark content to read later
Select your specific areas of interest
View gvhd content recommended for you
Addition of ATG to standard prophylaxis reduces incidence of acute and chronic GvHD
|
Addition of ATG to standard GvHD prophylaxis has been shown to reduce the incidence of acute and chronic GvHD; however, it may increase the risk of relapse.1 A retrospective, real-world, cohort study published by Bai et al.1 in Acta Haematologica compared ATG + standard GvHD prophylaxis (CSA + MTX) with the standard prophylaxis alone. The study included 210 patients undergoing unrelated donor allogeneic HSCT, of which 140 received ATG + CSA + MTX and 70 received CSA + MTX alone. The primary outcomes of the study were cumulative incidence of acute and chronic GvHD at 1- and 2-years post-HSCT.1
|
| Key learnings: |
|
The incidence of any grade aGvHD was significantly lower in patients treated with ATG vs those without (51.4% vs 70%; p = 0.010). The incidence of chronic GvHD at 1-year (36.4% vs 62.9%; p < 0.001) and 2-years (40.0% vs 65.7%; p < 0.001) post-allo-HSCT was lower in the ATG vs non-ATG group. |
|
GvHD-related mortality was lower in the ATG group (4.3% vs. 18.5%). However, the 2-year OS was similar between the ATG and non-ATG groups (65.0% vs 64.3%). In the ATG group, the rate of relapse post-HSCT was higher at 1-year (24.3% vs 14.3%; p = 0.09) and 2-years (31.4% vs 17.1%; p = 0.216) compared with the non-ATG group. |
|
ATG use did not increase the overall incidence of cytomegalovirus (p = 1.000) or Epstein-Barr virus reactivation (p = 0.104), although the number of patients requiring hospital admissions due to viral reactivations was higher in the ATG vs non-ATG groups (7 vs 0). |
|
Addition of ATG to standard GvHD prophylaxis effectively reduced GvHD incidence and severity, potentially improving GvHD-free survival. Tailoring ATG dosing and timing may optimize outcomes while mitigating relapse risk in patients undergoing allo-HSCT. |
Abbreviations: aGvHD, acute graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplant; ATG, anti-thymocyte globulin; CSA, cyclosporine A; GvHD, graft-versus-host disease; MTX, methotrexate.
References
Please indicate your level of agreement with the following statements:
The content was clear and easy to understand
The content addressed the learning objectives
The content was relevant to my practice
I will change my clinical practice as a result of this content
