• Giorgia Battipaglia, Myriam Labopin, Rose-Marie Hamladji, Didier Blaise, Patrice Chevallier, Eolia Brissot, Armin Gerbitz, Gerard Socié, Boris Afanasyev, Fabio Ciceri, Ellen Meijer, Yener Koc, Jan J Cornelissen, Anne Huynh, Hakan Ozdogu, Johan Maertens, Franciane Paul, Hélène Labussière-Wallet, Annalisa Ruggeri, Mahmoud Aljurf, Ali Bazarbachi, Bipin Savani, Arnon Nagler, and Mohamad Mohty.
• Hematology Department, Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, Paris, France.
• Cancer. 2021 Jan 15; 127 (2): 209-218.

BackgroundGraft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Addition of antithymocyte globulin (ATG) or post-transplantation cyclophosphamide (PTCY) to standard immunosuppressive agents reduces GVHD in different donor settings.MethodsWe compared the outcomes of adults with acute myeloid leukemia undergoing allo-HSCT from HLA-identical sibling donors after the use of PTCY (n = 197) or ATG (n = 1913).ResultsPatients in the PTCY group were younger than those in the ATG group (median age, 47 vs 54 years; P < .01). Peripheral blood was the most frequently used stem cell source, being significantly more frequent in the ATG group than in the PTCY group (95% vs 70% P < .01). The conditioning regimen was more frequently myeloablative in the PTCY group than in the ATG group (59% vs 48%; P < .01). Time to neutrophil engraftment was shorter in the ATG group than in the PTCY group (17 vs 20 days; P < .01). No differences were observed according to the other transplantation outcomes, except for chronic GVHD of all grades and extensive chronic GVHD at 2 years, which were significantly lower in the ATG group compared with the PTCY group (P < .02).ConclusionPTCY is feasible in an HLA-identical sibling setting, and despite similar outcomes, ATG may be associated with lower incidence of chronic GVHD.© 2020 American Cancer Society.

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