Thymoglobulin Prevents Chronic Graft-versus-Host Disease, Chronic Lung Dysfunction, and Late Transplant-Related Mortality: Long-Term Follow-Up of a Randomized Trial in Patients Undergoing Unrelated Donor Transplantation

The incidence of chronic graft-versus-host disease (GVHD) at last follow-up is lower in patients who receive antithymocyte globulin (ATG) in the conditioning regimen: this is more significant for extensive chronic GVHD.

There was a significantly higher cumulative incidence (CI) of chronic lung dysfunction in patients randomized to the non-ATG arm.

Bidimensional plots of forced vital capacity (FVC) expressed as percentage of predicted in patients who received or did not receive ATG and days after BMT. The linear fit for trend and 95% confidence limits (CL) are shown. FVC (percentage of predicted) and days from BMT are displayed on the y- and x-axis, respectively. Vertical bars represent determinations with 95% CL. ATG patients (58 determinations in 22 patients) show a relatively stable FVC (percentage of predicted), whereas the non-ATG group (38 determinations in 16 patients) shows a continuous decline in this parameter with time.

A, Actuarial survival from transplantation of patients randomized to the ATG arm (n = 56) or non-ATG arm (n = 53). B, Actuarial survival of patients randomized to the ATG arm (n = 29) or non-ATG arm (n = 28) who were alive 1 year after transplantation.

A, Cumulative incidence (CI) of transplant-related mortality (TRM) of patients randomized to the ATG arm (n = 56) or non-ATG arm (n = 53). B, Actuarial 9-year survival of patients randomized to the ATG arm (n = 29) or non-ATG arm (n = 28) who were alive 1 year after transplantation.