1. ¹Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Germany
2. ²Department of Bone Marrow Transplantation, University Hospital München, Germany
3. ³Department of Medicine, University Hospital Freiburg, Germany
4. ⁴Department of Bone Marrow Transplantation, University Hospital Essen, Germany
5. ⁵German Clinic for Diagnostic, Center of Bone Marrow Transplantation, Wiesbaden, Germany
6. ⁶Medical Clinic I, University Hospital Dresden, Germany
7. ⁷Clinic for Bone Marrow Transplantation, Idar-Oberstein, Germany
8. ⁸Department of Mathematics in Medicine, University Hospital Hamburg-Eppendorf, Germany

Correspondence: Professor Dr AR Zander, University Hospital Hamburg-Eppendorf, Bone Marrow Transplantation, Martinistr. 52, Hamburg 20246, Germany

Received 24 September 2002; Accepted 9 March 2003.

Abstract

Matched unrelated donor transplants have an increased risk of severe graft-versus-host disease and transplant-related mortality (TRM). ATG has been introduced to decrease GvHD and to facilitate engraftment. We conducted a retrospective analysis of 333 patients with chronic myelogenous leukemia, who were treated with Fresenius ATG (n=145, average=90 mg/kg bw, range 40–90 mg/kg bw) or standard immunosuppression without ATG (n=188). Both groups were comparable regarding distribution of age, sex, HLA-matched vs mismatched donors. ATG Fresenius led to a faster leukocyte engraftment, decreased the incidence of acute GvHD and TRM (P=0.01 and P=0.03) and led to a significant better overall survival (70 vs 57%, P=0.03). We concluded that a prospective randomized study is needed to evaluate the definite role of ATG in hemopoietic stem cell transplantation.