ATG Is an Effective Prophylaxis Against GVHD in Myelofibrosis Patients Undergoing Transplant

In vivo T-cell depletion with antithymocyte/antilymphocyte globulin (ATG) as part of a conditioning regimen prior to hematopoietic stem cell transplantation (HSCT) results in a notable reduction in graft-versus-host disease (GVHD), according to a study will be presented at the 65th ASH Annual Meeting & Exposition, which is taking place December 9-12 in San Diego, California.

In this multicenter study of 7 European and US academic transplant centers, Kristin Rathje and colleagues analyzed 806 (513 ATG, 293 non-ATG) GVHD prophylaxis patients. The study’s primary outcome of interest was GVHD-free, relapse-free survival (GRFS).  Secondary end points included acute and chronic GVHD, relapse incidence, nonrelapse mortality, and overall survival.

The results showed the positive efficacy of ATG, as the researchers observed that GVHD grade II-IV was 35% (95% CI, 31%-39%) for the ATG group versus 58% (95% CI, 52%-64%) for the non-ATG group. Overall, multivariable modeling showed a notable reduction in the risk of GVHD or relapse in the ATG group (hazard ratio, 0.85; 95% CI, 0.79-0.91; P=0.007).

“The use of ATG as GVHD prophylaxis in patients with myelofibrosis undergoing HSCT resulted in significantly reduced GRFS. This effect was mainly driven by a significant reduction in acute GVHD,” the researchers concluded.

Reference

Rathje K, Gagelmann N, Salit R, et al. ATG/ATLG improves GvHD-free and relapse-free survival in myelofibrosis undergoing hematopoietic stem cell transplantation. Abstract #3572. Presented at the 65th ASH Annual Meeting & Exposition; December 9-12, 2023; San Diego, California.