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Administration of anti-thymocyte globulin: a comparison of two protocols

Bone Marrow Transplantation volume 49, pages 1535–1537 (2014)Cite this article

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Antithymocyte globulin (ATG) can be utilized in allogeneic hematopoietic cell transplantation (allo-HCT) conditioning regimens to reduce the risk of GVHD.1, 2, 3 Although the overall goal of ATG is immunosuppressive in nature, infusion of foreign proteins from the rabbit or equine source can lead to an initial immune response and subsequent infusion reaction symptoms (fever, chills, hypertension and tachycardia) frequently occur.4, 5, 6, 7, 8

Despite the high incidence of these reactions, strategies for optimal administration of ATG and management of these infusion reaction symptoms are not well documented in the literature. Product labeling recommends premedications (corticosteroid, acetaminophen, antihistamine-1) and suggests a 6-h initial administration time and at least 4 h for administration of subsequent infusions.6 However, aside from premedication and slowing the infusion rate, recommendations are not made regarding the prevention and management of ATG-related infusion reactions.

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Authors and Affiliations

  1. Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA

    A B Clemmons & M E Hartranft

  2. Georgia Regents University Cancer Center, Augusta, GA, USA

    A B Clemmons, V Kota, J Pantin & H Salman

  3. Department of Pharmacy, Georgia Regents Medical Center, Augusta, GA, USA

    A B Clemmons & M E Hartranft

  4. Department of Medicine, Georgia Regents Medical Center, Augusta, GA, USA

    V Kota, J Pantin & H Salman

  5. Division of Hematology, Department of Internal Medicine, Bone Marrow Transplant Program, The Ohio State University, Columbus, OH, USA

    F T Awan

  6. Winship Cancer Institute of Emory University, Atlanta, GA, USA

    A P Jillella

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  1. A B Clemmons
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Correspondence to A B Clemmons.

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Clemmons, A., Hartranft, M., Kota, V. et al. Administration of anti-thymocyte globulin: a comparison of two protocols. Bone Marrow Transplant 49, 1535–1537 (2014). https://doi.org/10.1038/bmt.2014.174

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