Application prospect of low-dose porcine anti-thymocyte globulin in HLA-matched sibling donor transplantation

Abstract

ABSTRACTObjective To investigate the preventive effect of low-dose porcine anti-thymocyte globulin (P-ATG) on graft versus host disease (GVHD) in patients' donors over 40 years old or female donors undergoing HLA-matched sibling donor hematopoietic stem cell transplantation (MSD-HSCT).Methods The clinical data of 30 patients received Low-dose Porcine antithymocyte globulin (P-ATG) as a part of the conditioning regimen (the P-ATG group), while the other 30 patients didn’t receive ATG (the Non-ATG group).Results There was a significant difference in the incidence of aGVHD ([23.3 (10.1–39.7) %] vs [50.0 (30.8–66.5) %], P = 0.028), grade II–IV aGVHD ([16.7 (5.94–32.1) %] vs [40.0 (22.4–57.0) %], P = 0.049) and chronic GVHD (cGVHD) ([22.4 (6.03–45.1) %] vs [69.0 (43.4–84.8) %], P = 0.001) between two groups. But there was no significant difference in terms of moderate-severe cGVHD (P = 0.129), 1-year relapse rate (P = 0.742), non-relapse mortality (P = 0.237), or overall survival (P = 0.441).Conclusion The application of low-dose P-ATG in patients/donors over 40 years old or female donors undergoing MSD-HSCT for hematological malignancy can significantly reduce the incidence of aGVHD, grade II–IV aGVHD and cGVHD, doesn’t increase the risk of relapse.

Keywords

• Porcine anti-thymocyte globulin
• MSD-HSCT
• aGVHD