Background: Since the first successful bone marrow transplant in 1959, thousands of patients with lethal diseases such as severe leukemia, a plastic anemia, and inherited immune deficiencies have been successfully treated with hematopoietic stem cells (HSC). But for all the success stories, transplant physicians seeking to make HSC safer and more widely available continue to grapple with the problems of a limited donor pool, graft rejection, and graft vs.-host disease (GVHD). Bone marrow for many years was virtually the only source of HSC-self-renewing, unspecialized cells that give rise to all of the hematologic and immunologic cells-but transplant physicians increasingly are making use of stem cells collected from peripheral blood or the umbilical cord.
Objective: The aim of this work is to study the effect of receiving ATG in allo-HSCT (Hematopoietic Stem Cell Transplantation) on morbidity as GVHD; type of infections; frequency& mortality and survival rate
Patients and Methods: This was an observational cohort retrospective & prospective study, done on 200 patients collected from bone marrow transplantation units at Ain-Shams University& International Medical Center, Cairo-Egypt from August, 2019August, 2021. All participants underwent to clinical examination, laboratory findings, flowcytometry & cytogenetic analysis and all required investigations after explanation of the procedure to the patients and getting a formal consent. This study was approved by the ethical committee of faculty of medicine, Cairo, Al-Azhar University.
Results: there was a statistical difference (P- value <0.05) in the incidence and severity of GVHD between the two studied groups which was lower in the ATG arm than non ATG. Also, ATG was associated with a higher rate of infection which was also statistically significant (P-value <0.05) between the studied gropes. As regard survival rates ATG was associated with a higher survival rate which was statistically significant (P-value <0.05).
Conclusion: ATG was associated with a lower incidence rate and severity of GVHD whether acute or chronic but, on the contrary was associated with increased risk of infections.