尽管过去几十年免疫疗法取得了显着进展，但同种异体造血干细胞移植（allo-HCT）仍然是一种有前途的、具有潜在治愈性的治疗方式。只有少数研究对两种流行的兔抗胸腺细胞球蛋白 (r-ATG) 制剂进行了直接比较，特别是胸腺球蛋白（ATG-T，以前称为 Genzyme）和 Grafalon（ATG-G，以前称为费森尤斯）。我们回顾性分析的主要目的是比较接受匹配或不匹配无关供者 (MUD/MMUD) 同种异体 HCT 的成年患者与基于 ATG-T 或 ATG 的移植物抗宿主病 (GvHD) 预防的结果-G。总共纳入了 87 名 2012 年至 2022 年间接受过异基因 HCT 的患者。我们观察到 ATG-T 和 ATG-G 在急性移植物抗宿主病 (aGvHD) 的发生方面没有显着差异，无论其严重程度如何。相反，与 ATG-G 组相比，ATG-T 组的慢性移植物抗宿主病 (cGvHD) 发生率较低（7.5% vs. 38.3%，p = 0.001）。多变量分析证实了 ATG-G 对 cGvHD 的负面影响（HR 8.12，95% CI 2.06-32.0，p = 0.003）。使用 ATG-T 治疗的患者表现出巨细胞病毒 (CMV) 再激活的发生率较高（70% vs. 31.9%，p < 0.001），移植和 CMV 之间的时间较短（<61 天，77.8% vs. 33.3%，p = 0.008）和更高的 CMV 拷贝数中位数（1000 vs. 0，p = 0.004）。值得注意的是，尽管 ATG-T 队列中 CMV 再激活的发生率较高，但与 ATG-G 相比，大多数患者没有症状（85.7% vs. 43.8%，p = 0.005）。通过多变量分析，只有 aGvHD 对 CMV 再激活有影响（HR 0.18，95% CI 0.04-0.75，p = 0.019）。最后，在比较 ATG-T 和 ATG-G 时，我们观察到 5 年总生存率 (OS) 和 3 年无复发生存率 (RFS) 没有显着差异（32.0% 与 40.3%，p = 0.423； 66.7% 与 60.4%，分别为 p = 0.544）。

Despite notable advancements in immunotherapy in the past decades, allogeneic hematopoietic stem cell transplantation (allo-HCT) remains a promising, potentially curative treatment modality. Only a limited number of studies have performed a direct comparison of two prevalent rabbit anti-thymocyte globulin (r-ATG) formulations-specifically, Thymoglobuline (ATG-T, formerly Genzyme) and Grafalon (ATG-G, formerly Fresenius). The primary objective of our retrospective analysis was to compare the outcomes of adult patients undergoing matched or mismatched unrelated donor (MUD/MMUD) allo-HCT, with a graft-versus-host disease (GvHD) prophylaxis based on either ATG-T or ATG-G. A total of 87 patients who had undergone allo-HCT between 2012 and 2022 were included. We observed no significant differences between ATG-T and ATG-G concerning the occurrence of acute graft-versus-host disease (aGvHD), regardless of its severity. Conversely, chronic graft-versus-host disease (cGvHD) occurred less frequently in the ATG-T group compared to the ATG-G group (7.5% vs. 38.3%, p = 0.001). The negative impact of ATG-G on cGvHD was confirmed by multivariate analysis (HR 8.12, 95% CI 2.06-32.0, p = 0.003). Patients treated with ATG-T manifested a higher incidence of cytomegalovirus (CMV) reactivations (70% vs. 31.9%, p < 0.001), with a shorter time between transplant and CMV (<61 days, 77.8% vs. 33.3%, p = 0.008) and a higher median CMV copy number (1000 vs. 0, p = 0.004). Notably, despite a higher occurrence of CMV reactivations in the ATG-T cohort, most patients were asymptomatic compared to ATG-G (85.7% vs. 43.8%, p = 0.005). By multivariate analysis, only aGvHD had an influence on CMV reactivations (HR 0.18, 95% CI 0.04-0.75, p = 0.019). Finally, we observed no significant differences in terms of 5-year overall survival (OS) and 3-year relapse-free survival (RFS) while comparing ATG-T and ATG-G (32.0% vs. 40.3%, p = 0.423; 66.7% vs. 60.4%, p = 0.544, respectively).