Adding anti-thymocyte globulin (ATG) to a myeloablative conditioning regimen can cut the 2-year rate of chronic GVHD in half, according to results of a multi-center, prospective randomized trial of 168 patients transplanted for acute leukemias. At a median follow-up of 24 months, the cumulative incidence of chronic GVHD was 32.2% in the ATG group and 68.7% in the non-ATG group (p<0.001). There were no significant between-group differences in the rates of relapse, infectious complications, acute GVHD, or adverse events. Although 2-year overall survival in the ATG and non-ATG group were comparable - 74.1% vs. 77.9%, respectively (p=0.46) - the rate of chronic GVHD-free/relapse-free survival at 2 years was significantly higher in the ATG group than in the non-ATG group: 36.6% vs. 16.8%, respectively (p=0.005).
ATG Significantly Lowers Rate of Chronic GVHD