{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:04:24Z","timestamp":1760144664756,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Despite notable advancements in immunotherapy in the past decades, allogeneic hematopoietic stem cell transplantation (allo-HCT) remains a promising, potentially curative treatment modality. Only a limited number of studies have performed a direct comparison of two prevalent rabbit anti-thymocyte globulin (r-ATG) formulations\u2014specifically, Thymoglobuline (ATG-T, formerly Genzyme) and Grafalon (ATG-G, formerly Fresenius). The primary objective of our retrospective analysis was to compare the outcomes of adult patients undergoing matched or mismatched unrelated donor (MUD\/MMUD) allo-HCT, with a graft-versus-host disease (GvHD) prophylaxis based on either ATG-T or ATG-G. A total of 87 patients who had undergone allo-HCT between 2012 and 2022 were included. We observed no significant differences between ATG-T and ATG-G concerning the occurrence of acute graft-versus-host disease (aGvHD), regardless of its severity. Conversely, chronic graft-versus-host disease (cGvHD) occurred less frequently in the ATG-T group compared to the ATG-G group (7.5% vs. 38.3%, p = 0.001). The negative impact of ATG-G on cGvHD was confirmed by multivariate analysis (HR 8.12, 95% CI 2.06\u201332.0, p = 0.003). Patients treated with ATG-T manifested a higher incidence of cytomegalovirus (CMV) reactivations (70% vs. 31.9%, p &lt; 0.001), with a shorter time between transplant and CMV (&lt;61 days, 77.8% vs. 33.3%, p = 0.008) and a higher median CMV copy number (1000 vs. 0, p = 0.004). Notably, despite a higher occurrence of CMV reactivations in the ATG-T cohort, most patients were asymptomatic compared to ATG-G (85.7% vs. 43.8%, p = 0.005). By multivariate analysis, only aGvHD had an influence on CMV reactivations (HR 0.18, 95% CI 0.04\u20130.75, p = 0.019). Finally, we observed no significant differences in terms of 5-year overall survival (OS) and 3-year relapse-free survival (RFS) while comparing ATG-T and ATG-G (32.0% vs. 40.3%, p = 0.423; 66.7% vs. 60.4%, p = 0.544, respectively).<\/jats:p>","DOI":"10.3390\/cancers16101891","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T03:24:48Z","timestamp":1715829888000},"page":"1891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing the Outcomes of Matched and Mismatched Unrelated Allogeneic Hematopoietic Stem Cell Transplantation with Different Anti-Thymocyte Globulin Formulations: A Retrospective, Double-Centre Experience on Behalf of the Polish Adult Leukemia Group"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8735-3076","authenticated-orcid":false,"given":"Ugo","family":"Giordano","sequence":"first","affiliation":[{"name":"Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, 50-367 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Mordak-Domaga\u0142a","sequence":"additional","affiliation":[{"name":"Lower Silesian Center of Oncology, Pulmonology and Hematology, 53-439 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Sobczyk-Kruszelnicka","sequence":"additional","affiliation":[{"name":"Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Giebel","sequence":"additional","affiliation":[{"name":"Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 61-701 Pozna\u0144, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9442-989X","authenticated-orcid":false,"given":"Krzysztof D.","family":"Dudek","sequence":"additional","affiliation":[{"name":"Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3555-2887","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Dybko","sequence":"additional","affiliation":[{"name":"Lower Silesian Center of Oncology, Pulmonology and Hematology, 53-439 Wroclaw, Poland"},{"name":"Department of Oncology and Hematology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1200\/JCO.2010.33.7212","article-title":"Long-Term Survival and Late Deaths after Allogeneic Hematopoietic Cell Transplantation","volume":"29","author":"Wingard","year":"2011","journal-title":"J. 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