A retrospective analysis study published in Bone Marrow Transplantation demonstrated the feasibility of using anti-thymocyte globulin (ATG) for HLA-mismatched truly nonmyeloablative Flu-TBI hematopoietic cell transplantation (HCT). This study provides among the first transplant outcome data on the impact of ATG in HLA-mismatched truly nonmyeloablative HCT.
Patients receiving allogeneic HCT are at risk of developing Graft Versus Host Disease (GVHD), which ultimately hinders patients' survival rates and their quality of life long-term. Nonmyeloablative regimens are commonly administered in elderly or otherwise medically unfit patient populations, but still possess the risk of GVHD. At 3-years, a GVHD free and relapse free survival rate (GRFS) of approximately 30% in HLA-matched donors is observed. Currently, a triple drug strategy comprised of cyclosporine A (CsA), mycophenolate mofetil (MMF) resulting in less GVHD in these patients has been employed.
In this study, the median age was 56 years, with 54% of patients being male. The researchers found a 52% overall survival (OS) rate, a 43% relapse-free survival, and 38% GVHD free and relapse free survival rate (GRFS) at 4-years. While the authors highlight the limitations of the retrospective nature of this study, these findings suggest that ATG may be used as an alternative to triple drug strategies.
van der Velden, W.J.F.M., Choi, G., de Witte, M.A. et al. Anti-thymocyte globulin with CsA and MMF as GVHD prophylaxis in nonmyeloablative HLA-mismatched allogeneic HCT. Bone Marrow Transplant (2021).
Tags: GVHD, HCT, Allogeneic, prophylaxis, globulin, CsA, MMF, HLA, allogeneic HCT