COMPARISON BETWEEN EQUINE AND RABBIT ANTI-THYMOCYTE GLOBULIN (ATG) USED
IN CONDITIONING FOR PEDIATRIC PATIENTS UNDERGOING HEMATOPOIETIC STEM
CELL TRANSPLANTATION
Abstract
Background: HSCT related complications and disease relapse are major
obstacles in successful transplantation. Addition of ATG has shown to
reduce rejection and Graft Vs Host Disease (GVHD) incidence
significantly. Procedure: Here we report single center retrospective
analysis for relative efficacy of rabbit and equine ATG during
conditioning of pediatric patients who underwent HSCT. Results: Rabbit
or Equine ATG were used as a part of conditioning regimen in 117
pediatric patients. Equine ATG group was labeled as group-1 and rabbit
ATG as group-2. Both groups were analyzed for transplant related
complications and outcome. In thalassemia, outcomes were comparable
except Group-1 had more cases of proven bacterial infection (p=0.07) and
veno-occlusive disease (p=0.03). In SAA, Group-1 had early neutrophil
and platelet engraftment with less number of proven bacterial
infections. Acute GVHD, chronic GVHD, median chimerism at day+30 and
day+90 and overall survival (OS) was comparable in two groups, both in
thalassemia and SAA patients. Analysis of 7 hematological malignancy
cases and 10 immunodeficiency disorders also showed similar results.
Conclusion: In conclusion, effectiveness of rabbit and horse ATG were
similar in thalassemia, primary immunodeficiency patients and
hematological malignancy while in SAA equine ATG use was associated with
early neutrophil engraftment but OS in both groups were comparable.