Chemotherapy: Open Access
Open Access

Abstract

Infectious Complications Associated with the Use of Antithymocyte Globulin in Reduced Intensity Allogeneic Transplants

Kara Loth, Seema Naik, Leanne Kennedy, Gregory Russell, Denise Levitan, Kenneth Zamkoff and David Hurd

Purpose/Background: Due to its mechanism, the use of antithymocyte globulin (ATG) in reduced intensity conditioning allogeneic stem cell transplant (RIC allo-SCT) therapy may increase the incidence of infection. This study analyzes the type and incidence of infectious complications in RIC allo-SCT patients conditioned with or without ATG.

Methodology: Electronic medical records were utilized to identify all adult patients with hematologic malignancies receiving a RIC allo-SCT between January 2001 and December 2010. Patients with aplastic anemia or deceased within 30 days of transplant were excluded. The primary outcome included the rate of infection from engraftment to one year after transplant. Secondarily, the rates of infection during the engraftment period, incidence of acute and chronic GVHD, overall survival, and disease free status at one year were investigated.

Results: A total of 63 patients were included. More patients receiving ATG experienced infection (81% vs. 56%, p=0.11). In the ATG group, 45.2% of patients developed multiple infections versus 18.8% without ATG (p=0.032). There was no significant difference with regard to secondary outcomes.

Conclusion: The overall incidence of infection as well as the incidence of viral infection alone was significantly increased in patients treated with ATG. More studies need to be conducted to determine the significance of these infections and the potential for prophylaxis or reduced immunosuppression.