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
ATG vs ATLG as GvHD prophylaxis following allo-HSCT
|
Anti-thymocyte globulin (ATG) and anti-T-lymphocyte globulin (ATLG) have both demonstrated efficacy in preventing acute and chronic GvHD following allo-HSCT. However, a prospective comparison of outcomes with these distinct rabbit anti-lymphocyte globulins is lacking. Notarantonio et al.1 conducted a single-center, non-interventional study analyzing data from 114 adult patients who underwent allo-HSCT between 2017 and 2020 with either ATG (n = 50) or ATLG (n = 64) for GvHD prophylaxis. Patients received PBSCs from a matched related or unrelated donor. Immune monitoring was performed as part of the REAL-GREFFE trial (NCT03357172), with patients enrolled prospectively. Results were published in the American Journal of Hematology.1 |
| Key learnings |
| ATLG was associated with a 2-fold reduction in Grade II–IV acute GvHD incidence vs ATG (p = 0.006), and a higher 2-year GRFS (52% vs 30%; p = 0.027). |
| The incidence of relapse and chronic GvHD did not differ significantly between ATLG and ATG groups. However, a trend toward reduced relapse in the ATLG group was noted, with a cumulative incidence at 24 months of 17.22% vs 38.07% in the ATG group. |
| ATLG-treated patients had lower IL-15 but higher IL-21 levels between Day 0 and 60 post transplant, along with a reduction in PD1+ T cells, particularly in CD8+ subsets. T-cell recovery was comparable with ATLG and ATG. |
| ATLG may be preferred over ATG for GvHD prophylaxis due to improved acute GvHD prevention. However, an emphasis remains on personalized GvHD prophylaxis, considering factors such as pre-conditioning lymphocyte counts and cytokine profiles to optimize outcomes. |
Abbreviations: allo-HSCT, allogeneic hematopoietic stem cell transplant; ATG, anti-thymocyte globulin; ATLG, anti-T-lymphocyte globulin; GRFS, graft-versus-host disease-free relapse-free survival; GvHD, graft-versus-host disease; IL, interleukin; PBSC, peripheral blood stem cell.
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
