Low Dose ATG-Fresenius Might be Effective in the Prophylaxis of Severe Graft Versus Host Disease with Low Non-Relapse Mortality

• Published in: Blood 2015-12, Vol.126 (23), p.5468-5468
• Main Authors: Ormazabal Velez, Irati, Bermudez, Maria Aranzazu, Insunza, Andres, Yañez, Lucrecia, Richard, Carlos, Conde, Eulogio
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V126.23.5468.5468

Graft versus host disease (GvHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). ATG-Fresenius (ATG-F) has demonstrated its efficacy in reducing the risk of acute GvHD (aGvHD) and chronic GvHD (cGvHD) at a dose of 60 mg/kg (Finke J, Lancet Oncology, 2009; Sociè G, Blood, 2011), and at a dose of 30 mg/kg (Ayuk F, Biol Bone Marrow Transplant, 2008; Solano C, abstract EBMT, 2015). We analyzed as primary endpoint whether low dose ATG-F (21-32 mg/kg) might be effective in reducing the incidence of acute and chronic GvHD. The secondary endpoints were viral infections, non-relapse mortality (NRM), disease free survival (DSF) and overall survival (OS). Between September 2012 and December 2014, 22 patients who underwent HSCT received ATG-F in our hospital. Two patients were excluded because they received a second HSCT. We used ATG-F at a dose of 21 mg/kg (7 mg/Kg days -3,-2,-1) in the case of patients with hematologic malignancies who received a HSCT from an unrelated donor (UnD) with peripheral blood (PB) source and/or from a mismatched donor (MMD). ATG-F at a dose of 28-32 mg/kg (7-8 mg/kg days -4 to -1) was employed in aplasia. Median age was 53 years (9-68) and only 5 patients were