Addition of anti-thymocyte globulin to standard graft-versus-host disease prophylaxis versus standard treatment alone in patients with haematological malignancies undergoing transplantation from unrelated donors: final analysis of a randomised, open-label, multicentre, phase 3 trial

Post‐transplantation cyclophosphamide versus antithymocyte globulin in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation from HLA‐identical sibling donors: A retrospective analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

“…While the use of ATG may be considered as the standard of care in most centers in transplantations from unrelated donors, there is no consensus on its use in HLA‐identical sibling transplantation 28,29 . Herein, we show that a large number of European Centers use ATG in this setting, with favorable outcomes, particularly without significant increase in RI, providing further evidence that the use of ATG in this setting is feasible and allows favorable disease control, as previously reported 30 …”

Addition of Anti-thymocyte Globulin in Allogeneic Stem Cell Transplantation With Peripheral Stem Cells From Matched Unrelated Donors Improves Graft-Versus-Host Disease and Relapse Free Survival

“…Early studies suggested that adding ATG to GvHD prophylaxis was associated with delayed immune reconstitution and increased risk of viral infections, particularly cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation in addition to an increased risk of relapse (10). However, addition of ATG to GvHD prophylaxis has been shown in several randomized prospective trials to significantly reduce cGvHD and to improve GvHD and relapse free survival (GRFS) (11)(12)(13)(14)(15)(16). In the only double-blind trial in MUD / MAC allo-HSCT ATG lowered moderate to severe cGvHD, but progression free survival (PFS) and overall survival (OS) also were lower, indicating that additional analyses are needed to understand the appropriate role for ATG in allo-HSCT (19).…”

Hematopoietic cell transplant outcomes after myeloablative conditioning with fludarabine, busulfan, low‐dose total body irradiation, and rabbit antithymocyte globulin

“…Grade 3‐4 aGVHD was also remarkably low (9% among total and 6% among AML patients), probably also due to ATG (thymoglobulin). It is surprising that ATG has not been widely accepted for GVHD prophylaxis, as 3 randomized studies have demonstrated its superiority over calcineurin inhibitor + methotrexate only 32‐37 . The reason may be that other promising GVHD prophylaxes are being studied, including CD34 cell enrichment of grafts and post‐transplant cyclophosphamide.…”