Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Comparison of Different Rabbit Anti-thymocyte Globulin Formulations in the Prophylaxis of Graft-versus-Host Disease: A Systematic Review

Jarosław Dybko
ORCID logo ,
Ugo Giordano
* ORCID logo ,
Justyna Pilch
ORCID logo ,
Jakub Mizera
ORCID logo ,
Artur Borkowski
ORCID logo ,
Monika Mordak-Domagała
Version 1 : Received: 27 June 2023 / Approved: 28 June 2023 / Online: 28 June 2023 (10:20:03 CEST)

A peer-reviewed article of this Preprint also exists.

Dybko, J.; Giordano, U.; Pilch, J.; Mizera, J.; Borkowski, A.; Mordak-Domagała, M. Comparison of Different Rabbit Anti-Thymocyte Globulin Formulations in the Prophylaxis of Graft-Versus-Host Disease: A Systematic Review. J. Clin. Med. 2023, 12, 5449. Dybko, J.; Giordano, U.; Pilch, J.; Mizera, J.; Borkowski, A.; Mordak-Domagała, M. Comparison of Different Rabbit Anti-Thymocyte Globulin Formulations in the Prophylaxis of Graft-Versus-Host Disease: A Systematic Review. J. Clin. Med. 2023, 12, 5449.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a potentially curative treatment modality, frequently applied in patients suffering from haematological malignancies. In the last two decades, there have been multiple randomised controlled trials (RCTs), review articles, and meta-analyses addressing the efficacy of rabbit anti-thymocyte globulin (r-ATG) as a graft-versus-host disease (GvHD) prophylaxis. Nevertheless, only a few aimed to compare the effectiveness of different r-ATG formulations. We performed a systematic literature review of articles published since 2017 to this day utilising PubMed, Scopus, Cochrane, and MEDLINE, with the main endpoints being prophylaxis of acute GvHD (aGvHD) and chronic GvHD (cGvHD). We subjected to scrutiny a total of 5 studies, of which 4 compared the differences between Thymoglobulin (ATG-T) and Grafalon (ATG-G), and 1 discussed the impact of ATG-T dose. Overall cGvHD, aGvHD grades II-IV, TRM, OS, NRM, LFS, relapse, overall infections, and EBV reactivation do not seem to be affected by the type of utilised rATG. However, data on aGvHD grades III-IV, GRFS, moderate-severe cGvHD, and CMV reactivation is conflicting. Through our research, we sought to summarise the most recent findings concerning r-ATGs in allo-HCT, and provide insight into the differences between the targets and origin of various ATG formulations.

Keywords

anti-thymocyte globulin; acute graft-versus-host disease; chronic graft-versus-host disease; allogeneic stem cell transplantation; thymoglobuline; grafalon

Subject

Medicine and Pharmacology, Hematology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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