Lower dose of ATG combined with post-transplant cyclophosphamide for HLA matched RIC alloHCT is associated with effective control of GVHD and less viral infections. Issue 14 (6th December 2021)

• Record Type: Journal Article
• Authors: Salas, Maria Queralt; Atenafu, Eshetu G.; Law, Arjun Datt; Lam, Wilson; Pasic, Ivan; Chen, Carol; Kim, Dennis (Dong Hwan); Michelis, Fotios V.; Gerbitz, Armin; Lipton, Jeffrey Howard; Mattsson, Jonas; Kumar, Rajat; Viswabandya, Auro
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 14(2021)
• Page Start: 3373
• Page End: 3383
• Publication Date: 2021-12-06
• Subjects: Anti-thymocyte globulin -- post-transplant cyclophosphamide -- peripheral blood stem cell -- matched related donor -- matched unrelated donor -- allogeneic stem cell transplantation; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1966781
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: This study compares the outcomes before and after reducing the ATG dose from 4.5 to 2 mg/kg, in a combination of PTCy and CsA for GVHD prevention, in 250 patients treated with HLA matched RIC PB-alloHCT (70% received 4.5 mg/kg and 30% received 2 mg/kg). The incidences of grade II-IV and III-IV aGVHD at day +100, and moderate/severe cGVHD at 1-year were 12.6% vs. 20% ( p = 0.431), 3.6% vs. 4.5% ( p = 0.935), and 10.9% vs. 26.1% ( p = 0.480), respectively. PTLD (9.1% vs. 1.3%, p = 0.026) and viral infections (30.3% vs. 12%; p = 0.001) were lower for those treated with 2 mg/kg of ATG. The reduction of the ATG dose resulted in a comparable OS (2-year: 64.7% vs. 64.7%), GRFS (2-year: 48.0% vs. 44.5%), RFS (2-year: 57.0% vs. 62.0%), and NRM (2-year: 17.8 vs. 14.9). The use of (2 mg/kg) ATG-PTCy-CsA for HLA matched RIC alloHCT results in lower viral infections, and incomparable GVHD preventive effect and survival rates.