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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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Arai Y, Jo T, Matsui H, Kondo T, Takaori-Kondo A. Efficacy of antithymocyte globulin for allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis. Leuk Lymphoma. 2017;58:1840–8.
Bosch M, Dhadda M, Hoegh-Petersen M, Liu Y, Hagel L, Podgorny P, et al. Immune reconstitution after anti-thymocyte globulin-conditioned hematopoietic cell transplantation. Cytotherapy. 2012;14:1258–75.
Soiffer RJ, Lerademacher J, Ho V, Kan F, Artz A, Champlin RE, et al. Impact of immune modulation with anti-T-cell antibodies on the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Blood. 2011;117:6963–70.
Divito SJ, Aasebø AT, Matos TR, Hsieh PC, Collin M, Elco CP, et al. Peripheral host T cells survive hematopoietic stem cell transplantation and promote graft-versus-host disease. J Clin Invest. 2020;130:4624–36.
Li N, Chen Y, He W, Yi T, Zhao D, Zhang C, et al. Anti-CD3 preconditioning separates GVL from GVHD via modulating host dendritic cell and donor T-cell migration in recipients conditioned with TBI. Blood. 2009;113:953–62.
Gul Z, Van Meter E, Abidi M, Ditah I, Abdul-Hussein M, Deol A, et al. Low blood lymphocyte count at 30 days post transplant predicts worse acute GVHD and survival but not relapse in a large retrospective cohort. Bone Marrow Transpl. 2015;50:432–7.
Thoma MD, Huneke TJ, DeCook LJ, Johnson ND, Wiegand RA, Litzow MR, et al. Peripheral blood lymphocyte and monocyte recovery and survival in acute leukemia postmyeloablative allogeneic hematopoietic stem cell transplant. Biol Blood Marrow Transpl. 2012;18:600–7.
Admiraal R, van Kesteren C, Jol-van der Zijde CM, Lankester AC, Bierings MB, Egberts TC, et al. Association between anti-thymocyte globulin exposure and CD4+ immune reconstitution in paediatric haemopoietic cell transplantation: a multicentre, retrospective pharmacodynamic cohort analysis. Lancet Haematol. 2015;2:e194–203.
Ranti J, Kurki S, Salmenniemi U, Putkonen M, Salomäki S, Itälä-Remes M. Early CD8+-recovery independently predicts low probability of disease relapse but also associates with severe GVHD after allogeneic HSCT. PLoS One. 2018;13:e0204136.
Minculescu L, Marquart HV, Friis LS, Petersen SL, Schiødt I, Ryder LP, et al. Early Natural Killer Cell Reconstitution Predicts Overall Survival in T Cell-Replete Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transpl. 2016;22:2187–93.
Admiraal R, Nierkens S, Bierings MB, Bredius RGM, van Vliet I, Jiang Y, et al. Individualised dosing of anti-thymocyte globulin in paediatric unrelated allogeneic haematopoietic stem-cell transplantation (PARACHUTE): a single-arm, phase 2 clinical trial. Lancet Haematol. 2022;9:e111–20.
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.
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). https://doi.org/10.1038/s41409-022-01772-w