A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts

Abstract Both anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy) have shown prophylactic effects on graft-versus-host disease (GVHD) in multiple phase III studies. We conducted a comparative study of for low dose ATG (thymoglobulin) versus PTCy for GVHD prophylaxis in peripher...

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Main Authors: Souichi Shiratori, Junichi Sugita, Jun Ishikawa, Takashi Kuroha, Yasuo Mori, Tetsuya Eto, Senji Kasahara, Kentaro Fukushima, Mine Harada, Takanori Teshima
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-07263-4
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author Souichi Shiratori
Junichi Sugita
Jun Ishikawa
Takashi Kuroha
Yasuo Mori
Tetsuya Eto
Senji Kasahara
Kentaro Fukushima
Mine Harada
Takanori Teshima
author_facet Souichi Shiratori
Junichi Sugita
Jun Ishikawa
Takashi Kuroha
Yasuo Mori
Tetsuya Eto
Senji Kasahara
Kentaro Fukushima
Mine Harada
Takanori Teshima
author_sort Souichi Shiratori
collection DOAJ
description Abstract Both anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy) have shown prophylactic effects on graft-versus-host disease (GVHD) in multiple phase III studies. We conducted a comparative study of for low dose ATG (thymoglobulin) versus PTCy for GVHD prophylaxis in peripheral blood stem cell transplantation (PBSCT). The ATG (n = 67) and PTCy (n = 40) groups included patients enrolled in multicenter phase II studies (JSCT-ATG15 and JSCT-PTCY19, respectively). The probability of GVHD-free and relapse-free survival at 2 years as the primary endpoint was not significantly different between these two groups (57.9% for ATG vs. 67.8% for PTCy, P = 0.49). Both neutrophil and platelet engraftments were both significantly shorter in the ATG group than in the PTCy group (neutrophils: median 13 days vs. 15 days, P = 0.007; platelets: median 20 days vs. 27 days, P = 0.007). The cumulative incidences of acute and chronic GVHD, relapse, non-relapse mortality, and off-immunosuppressant use were similar between these two groups. The probabilities of overall and progression-free survival were 83.4% and 70.0% in the ATG group and 76.5% and 75.2% in the PTCy group, respectively, with no significant differences. These data indicate that low dose ATG and PTCy are equivalent for GVHD prophylaxis for PBSCT.
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spelling doaj-art-eba6b253f19f4660a4e959ef75b8a7392025-08-20T03:03:32ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-07263-4A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohortsSouichi Shiratori0Junichi Sugita1Jun Ishikawa2Takashi Kuroha3Yasuo Mori4Tetsuya Eto5Senji Kasahara6Kentaro Fukushima7Mine Harada8Takanori Teshima9Department of Hematology, Hokkaido University HospitalDepartment of Hematology, Sapporo Hokuyu HospitalDepartment of Hematology, Osaka International Cancer InstituteDepartment of Hematology, Nagaoka Red Cross HospitalDepartment of Hematology/Oncology, Kyushu University HospitalDepartment of Hematology, Hamanomachi HospitalDepartment of Hematology, Gifu Municipal HospitalDepartment of Hematology and Oncology, Osaka University HospitalKaratsu Higashimatsuura Medical CenterDepartment of Hematology, Hokkaido University HospitalAbstract Both anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy) have shown prophylactic effects on graft-versus-host disease (GVHD) in multiple phase III studies. We conducted a comparative study of for low dose ATG (thymoglobulin) versus PTCy for GVHD prophylaxis in peripheral blood stem cell transplantation (PBSCT). The ATG (n = 67) and PTCy (n = 40) groups included patients enrolled in multicenter phase II studies (JSCT-ATG15 and JSCT-PTCY19, respectively). The probability of GVHD-free and relapse-free survival at 2 years as the primary endpoint was not significantly different between these two groups (57.9% for ATG vs. 67.8% for PTCy, P = 0.49). Both neutrophil and platelet engraftments were both significantly shorter in the ATG group than in the PTCy group (neutrophils: median 13 days vs. 15 days, P = 0.007; platelets: median 20 days vs. 27 days, P = 0.007). The cumulative incidences of acute and chronic GVHD, relapse, non-relapse mortality, and off-immunosuppressant use were similar between these two groups. The probabilities of overall and progression-free survival were 83.4% and 70.0% in the ATG group and 76.5% and 75.2% in the PTCy group, respectively, with no significant differences. These data indicate that low dose ATG and PTCy are equivalent for GVHD prophylaxis for PBSCT.https://doi.org/10.1038/s41598-025-07263-4
spellingShingle Souichi Shiratori
Junichi Sugita
Jun Ishikawa
Takashi Kuroha
Yasuo Mori
Tetsuya Eto
Senji Kasahara
Kentaro Fukushima
Mine Harada
Takanori Teshima
A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
Scientific Reports
title A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
title_full A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
title_fullStr A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
title_full_unstemmed A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
title_short A comparative study of GVHD prophylaxis using low dose ATG versus PTCy for PBSCT based on two independent prospective cohorts
title_sort comparative study of gvhd prophylaxis using low dose atg versus ptcy for pbsct based on two independent prospective cohorts
url https://doi.org/10.1038/s41598-025-07263-4
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