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Conditioning

The effect of equine antithymocyte globulin on the outcomes of reduced intensity conditioning for AML

Bone Marrow Transplantation volume 49, pages 1498–1504 (2014)Cite this article

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Abstract

Whether or not the benefits of antithymocyte globulin (ATG) on engraftment and GVHD are offset by increased risk of relapse, delayed T-cell recovery and increased infections remains controversial. We retrospectively studied the effect of ATG in 144 AML patients, 34 of whom received ATG, undergoing reduced intensity conditioning (RIC) umbilical cord blood transplantation (UCB) or HLA-matched sibling PBSC. ATG patients had not received intensive chemotherapy for 3 months before transplantation for UCB, 6 months for PBSC. There were no differences in engraftment between ATG and non-ATG patients. The cumulative incidences of TRM as well as acute and chronic GVHD in ATG-treated patients were not statistically different. ATG patients had significantly more infections between 46 and 180 days post transplantation. Unexpectedly, after adjusting for donor type, relapse was lower among ATG recipients (relative risk (RR) 0.5, 95% confidence interval (CI) 0.3–1.0, P=0.04). In summary, administration of ATG to AML patients undergoing RIC had no adverse impact on major clinical outcomes. ATG may be indicated for patients at higher risk of graft failure after allogeneic hematopoietic cell transplantation (allo-HCT).

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Acknowledgements

This work was supported in part by grants from the National Cancer Institute P01 CA65493 (CGB, JEW), the Children’s Cancer Research Fund (JEW, TED), Leukemia and Lymphoma Society Scholar in Clinical Research Award, grant R6029–07 (CGB).

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Authors and Affiliations

  1. Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA

    P Hagen, J E Wagner, T E DeFor, M Arora, E Warlick, D Weisdorf & C G Brunstein

  2. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA

    M Dolan

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  1. P Hagen
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  2. J E Wagner
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  3. T E DeFor
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  4. M Dolan
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  6. E Warlick
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  7. D Weisdorf
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  8. C G Brunstein
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Correspondence to C G Brunstein.

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Hagen, P., Wagner, J., DeFor, T. et al. The effect of equine antithymocyte globulin on the outcomes of reduced intensity conditioning for AML. Bone Marrow Transplant 49, 1498–1504 (2014). https://doi.org/10.1038/bmt.2014.183

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