Allogeneic hematopoietic stem cell transplantation using ATG: prophylaxis and treatment

Graft versus host disease (GVHD) following allogeneic hematopoietic stem cell transplantation is associated with an increase in patient transplant-related morbidity and mortality and a decrease in quality of life. Adequate immune suppression is critical to prevent GVHD without increasing the risk of developing a severe infection or relapse of malignancy. Anti-T cell globulin (ATG) combined with other immunosuppressive drugs can reduce the risk of severe acute GVHD and extensive chronic GVHD without enhancing the rate of severe infection or relapse of malignancy. Future research is warranted to determine the optimum ATG dosage, as the pharmacokinetics of ATG substantially differs among patients and impact transplant outcomes. Therefore, further studies are required to determine the therapeutic potential of ATG for steroid refractory GVHD.