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Split dose ATG strategy prevents grade III-IV acute GVHD and is associated with immune surrogates of GVL


Our split dose ATG strategy resulted in complete prevention of grade III-IV aGVHD, relatively low cGVHD, NRM, and high GRFS. It was associated with enhanced immune reconstitution, and relapse predictive phenotypes.

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Fig. 1: Clinical and immune phenotypic outcomes associated with split dose ATG.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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This research is supported with funds from The University of Nebraska Foundation. Presented in abstract form at the 57th European bone marrow transplant meeting, Prague, Czech March 2022.

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Authors and Affiliations



ZA, JT, and SH designed the study; SP and JY designed, executed, and analyzed flow cytometry data; ZG collected data and analyzed disease risk for relapse: KA, AH and SM collected and analyzed data; LM, KG and VRB analyzed data and adjudicated GVHD type and grading: EL and LS performed the statistical analysis of clinical outcomes and relapse immune correlates; MC performed statistical analysis of immune reconstitution phenotypes compared with healthy controls; ML, GB, CD, AK, JA, and JV analyzed clinical and immunologic data; and all authors wrote, reviewed, and approved the final version of the manuscript.

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Correspondence to Zaid Al-Kadhimi.

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Competing interests

VRB reports participating in Safety Monitoring Committee for Protagonist, and receiving consulting fees from Genentech, Incyte, Servier Pharmaceuticals LLC, and Abbvie, research funding (institutional) from Abbvie, Pfizer, Incyte, Jazz, and National Marrow Donor Program, and drug support (institutional) from Oncoceutics for a trial. KG consulting: Bayer consumer care, CTI biopharma, BMS, Blueprint Medicines, Jazz Pharmaceuticals, BioMarin Pharmaceuticals. Institutional funding: Samus therapeutics, Incyte, Pfizer, Autolus therapeutics. JV Consulting: Morphosys, Abbvie, Janssen, Astra-Zeneca, MEI Pharma, Daiichi Sankyo, Johnson and Johnson, Pharmacyclics, Genentech. Research: Loxo Pharma, Novartis, Kite.

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Al-Kadhimi, Z., Pirruccello, S., Gul, Z. et al. Split dose ATG strategy prevents grade III-IV acute GVHD and is associated with immune surrogates of GVL. Bone Marrow Transplant 57, 1629–1631 (2022).

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