The use of post-transplant cyclophosphamide (PTCy) notably attenuates the risk of acute graft-versus-host disease (aGVHD) compared with anti-thymocyte globulin (ATG), according to a study presented at the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience.
Researchers performed a comprehensive literature search of PubMed, Cochrane library, and EMBASE from inception through September 2020 for studies that compared the use of PTCy and ATG. Subsequently, they conducted a random effect meta-analysis of eight studies comprising 1,394 patients (PTCy, n=638; ATG, n=756).
Following analysis, the researchers observed a marked reduction in odds of aGVHD in the PTCy group (odds ratio [OR], 0.41; 95% confidence interval [CI], 0.22-0.76). However, the results showed there was no significant difference in the odds of chronic GVHD (OR, 0.74; 95% CI, 0.44-1.24) or relapse, (OR, 0.86; 95% CI, 0.59-1.25). Interestingly, the researchers noted, there was no significant increase in overall survival (OS) in the PTCy group.
“There is significantly decreased odd of aGVHD with the use of PTCy compared with ATG, but there is no significant decrease in odd of chronic GVHD or relapse,” the researchers concluded. They added that “there was a trend toward increased OS in the PTCy group, which may warrant further exploration in more details.”
Poonsombudlert K, et al. Post-Transplant Cyclophosphamide Versus Anti-Thymocyte Globulin as Graft-Versus-Host Disease Prophylaxis; A Meta-Analysis. Published for the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience; February 8-12, 2021.