1. ¹Clinic for Bone Marrow Transplantation and Hematology/Oncology, Idar-Oberstein, Germany
2. ²Deutsche Klinik für Diagnostik, BMT Unit, Wiesbaden, Germany
3. ³III Medical Clinic, Gutenberg University, Mainz, Germany
4. ⁴ALWP EBMT Office, Paris, France

Correspondence: Dr N Basara, Clinic for Bone Marrow Transplantation and Hematology/Oncology, Dr Ottmar-Kohler-St. 2, 55743 Idar-Oberstein, Germany. E-mail: NBasara@bmt-center-io.com

Received 19 July 2004; Accepted 28 January 2005; Published online 11 April 2005.

Abstract

A total of 155 patients with acute myeloid leukemia (AML) received hematopoietic stem cell transplants from unrelated donors after standard conditioning. Clinical outcome after the use of two different antithymocyte globulins for the prevention of graft-versus-host disease (GvHD) was analyzed in a retrospective study as follows: rabbit ATG (Thymoglobulin Sangstat/Genzyme, n=49, median age 42 years, 53% in CR, further ATG-S); rabbit ATG (ATG-Fresenius, n=38, median age 42 years, 58% in CR, further ATG-F) or no ATG (n=68, median age 36 years, 55% in CR). The groups were comparable regarding disease status at transplant, age, CMV status and cytogenetics. Grade III–IV acute GvHD was found in 15% in the ATG and 27% in the no ATG group (P=0.44). The most important independent risk factors for chronic GvHD (cGvHD) were the use of ATG, disease status at transplant and conditioning. cGvHD developed significantly more frequently in no ATG group. With the median follow-up of 34 months, the 5-year survival is 42% for those transplanted in CR. To conclude, these data demonstrate that the transplants performed in CR, with ATG, are associated with a good outcome, low incidence of cGvHD and no increase of relapse.