Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi - LARVOL DELTA

Efficacy and Safety of Combining r-ATG With PTCy for GvHD Prophylaxis in Haploidentical HSC Transplantation for Malignancies-A Systematic Review. (PubMed, J Cell Mol Med) - "Rabbit anti-thymocyte globulin (r-ATG) or post-transplant cyclophosphamide (PTCy) is effective in reducing GvHD in haploidentical-HSCT. Overall acute GvHD grade II-IV, moderate-to-severe chronic GvHD and GvHD-free relapse-free survival rates ranged from 11.50%-35.40%, 2.90%-17.78% and 21.80%-63%, respectively. Although r-ATG + PTCy treatment lowered GvHD incidence and increased survival rates, cytomegalovirus and Epstein-Barr virus reactivation were observed; therefore, more investigations on this treatment are needed, especially on dosing and timing when used for HSCT."

Journal • Review • Acute Graft versus Host Disease • Bone Marrow Transplantation • Chronic Graft versus Host Disease • Cytomegalovirus Infection • Epstein-Barr Virus Infections • Graft versus Host Disease • Hematological Disorders • Hematological Malignancies • Immunology • Oncology • Transplantation

Outcomes of split-dose lymphocyte-adjusted rabbit ATG in allogeneic stem cell transplant recipients. (ASCO 2025) - " This retrospective, single-center review evaluated patients who received an allogeneic stem cell transplant from any donor type with rATG/tacrolimus/methotrexate prophylaxis between 1/2020 - 12/2022. ALC-adjusted rATG did not result in severe aGVHD and relapse outcomes were comparable to referenced literature. ALC recovery remained impaired for at least one year. Further standardization of ATG-dosing, including dose individualization, is needed, ideally in a prospective setting."

Clinical • Preclinical • Acute Graft versus Host Disease • Cytomegalovirus Infection • Epstein-Barr Virus Infections • Graft versus Host Disease • Immunology • Infectious Disease • Transplantation

12-Month Outcomes of a Prospective Randomized Trial Investigating Effects of IVIG on Top of rATG Versus rATG Alone in Pre-Sensitized Kidney Transplant Recipients: The INHIBIT Study. (PubMed, Transpl Int) - P3 | "We conducted a prospective, randomized single-center, open-label, Phase IIIb non-inferiority clinical pilot trial to compare the efficacy of IVIG (administered at a dose of 3 × 0.5 g/kg) versus no IVIG, in conjunction with rabbit anti-thymocyte globulin (5-7 mg/kg) induction, in pre-sensitized patients with donor-specific antibodies who had negative pre-transplantation Flow- and CDC-crossmatches, between July 2020 and November 2022...The results of this pilot study, although not definitive, do not support the use of IVIG-sparing regimens in HLA-incompatible kidney transplantation (NCT04302805). This study is registered on ClinicalTrials.gov under the identifier NCT04302805."

Clinical • Journal • Transplantation

Combined Thymoglobulin and Interleukin-2 Receptor Antagonist Induction Therapy in Kidney Transplantation Is Associated With Worse Delayed Graft Function, Acute Rejection, Graft Loss, and Mortality. (PubMed, J Surg Res) - "DIT was associated with higher risk of prolonged hospitalization, delayed graft function, acute rejection, graft failure and mortality compared to single drug induction. Further investigation with a randomized controlled trial is required to assess causation."

Journal • Cardiovascular • Cytomegalovirus Infection • Transplant Rejection • Transplantation • IL2RA

Study of efficacy and safety of eltrombopag in combination with rabbit anti-thymocyte globulin and cyclosporine A in treatment naive East-Asian patients with severe aplastic anemia (clinicaltrialsregister.eu) - P2 | N=36 | Sponsor: Novartis

New P2 trial • Anemia • Aplastic Anemia • Hematological Disorders

Comparing the noninfectious adverse effects of two rabbit anti-thymocyte globulin immunosuppression in kidney transplantation: a multicenter, retrospective study. (PubMed, Expert Opin Biol Ther) - "TEEs happened in about 5% of the patients. Peripheral administration of rATG without adding heparin, history of underlying diseases predisposing to TEEs, CMV infection, and recipient age over 40 years were found as risk factors for the occurrence of TEEs."

Adverse events • Journal • Preclinical • Retrospective data • Cardiovascular • Cytomegalovirus Infection • Hematological Disorders • Infectious Disease • Thrombosis • Transplantation

Over 1000 Pancreas Transplants in a Latin American Program. (PubMed, Transplantation) - "During the course of 25 y, our PT program has consistently maintained a high-volume activity and has recently emerged as one of the world's most active programs, conducting >60 PT procedures annually."

Journal • Cardiovascular • Chronic Kidney Disease • Diabetes • Hematological Disorders • Metabolic Disorders • Nephrology • Thrombosis • Transplantation • Type 1 Diabetes Mellitus

Precision Administration of Anti-thymocyte Globulin With or Without Verapamil (clinicaltrials.gov) - P2 | N=60 | Not yet recruiting | Sponsor: University of Florida | Trial completion date: Apr 2030 ➔ Jul 2030 | Initiation date: Apr 2025 ➔ Jul 2025 | Trial primary completion date: Apr 2028 ➔ Jul 2028

Trial completion date • Trial initiation date • Trial primary completion date • Diabetes • Metabolic Disorders • Type 1 Diabetes Mellitus

Total Body Irradiation and Astatine-211-Labeled BC8-B10 Monoclonal Antibody for the Treatment of Nonmalignant Diseases (clinicaltrials.gov) - P1/2 | N=40 | Recruiting | Sponsor: Fred Hutchinson Cancer Center | Suspended ➔ Recruiting

Enrollment open • Oncology • HLA-A • HLA-B • HLA-C • HLA-DQB1 • HLA-DRB1

Homozygous STAT-1 Loss of Function Presenting with Recurrent Respiratory Infections and Pneumocystis jirovecii Pneumonia (CIS 2025) - "She was started on prophylactic IVIG and acyclovir and regularly screened for EBV, CMV, and HHV-6...Ultimately, Pneumocystis jirovecii pneumonia was diagnosed by PCR from bronchoalveolar lavage; she improved with trimethoprimsulfamethoxazole...Given high risk for myco-bacterial infection, empiric treatment with azithromycin, amikacin, and linezolid was initiated...Planned conditioning regimen was rituximab, targeted dosing rATG, targeted busulfan, targeted fludarabine, and thiotepa...Graft-versus-host prophylaxis was tocilizumab and abatacept... Complete STAT1 deficiency is a severe immunodeficiency that is historically fatal in early life without curative HSCT. Our case supports the need for early transplant before the acquisition of and complications due to severe infections."

Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Infectious Disease • Novel Coronavirus Disease • Pneumonia • Primary Immunodeficiency • Pulmonary Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections • IFNG • STAT1

Imlifidase in Highly Sensitized Kidney Transplant Recipients with a Positive Crossmatch Against a Deceased Donor: Real-World Results from the First 30 Cases in France (EFI 2025) - "Patients received thymoglobulin, rituximab, tacrolimus, mycophenolate mofetil, and intravenous immunoglobulins in addition to imlifidase...A total of 22 patients (73%) developed at least one infection (1.7 ± 0.71 per patient). These real-world data demonstrate that imlifidase has an acceptable efficacy and safety profile in the medium term for selected patients, despite a high incidence of DSA rebound and rejection."

Clinical • Real-world • Real-world evidence • Antibody-mediated Rejection • Infectious Disease • Transplantation

Three years of kidney transplantation in the Yaounde General Hospital, Cameroon (ERA 2025) - "Twelve recipients received Basiliximab and one thymoglobulin as induction. In addition to mycophenolic acid, eleven received cyclosporine, and two received tacrolimus as maintenance therapy... Three years after the beginning of the first transplantation program in Cameroon, the outcome of patients is satisfactory. Local expertise has grown with total independence. However, the absence of renal pathology remains the main issue."

Clinical • Infectious Disease • Nephrology • Transplant Rejection • Transplantation

Kidney Transplant Outcomes in Highly Sensitized Patients with Preformed Donor-Specific Antibodies Using a DELISTING Strategy (ERA 2025) - "The implementation of delisting strategies optimizes the chances of KT in highly sensitized patients with preformed donor-specific antibodies. Despite a high incidence of acute rejection and infections, the majority of grafts remain functional with acceptable renal function. These findings highlight the effectiveness of delisting in improving access to transplantation in this complex population."

Clinical • Antibody-mediated Rejection • Infectious Disease • Transplant Rejection • Transplantation

Effect of rabbit anti-thymocyte globulin (rATG) induction in ABO-incompatible (ABOi) kidney transplantation: Single center retrospective cohort study (ERA 2025) - "Background and Aims:Development of desensitization protocols and induction regimens have enabled ABO-incompatible kidney transplantation (ABOi KT) with outcomes comparable to ABO-compatible (ABOc) KT. rATG induction in ABOi KT is comparable to basiliximab induction in death-censored graft survival and rejection-free survival. rATG induction showed better results in terms of overall graft survival and showed less infection-related complications or malignancies."

Preclinical • Retrospective data • Infectious Disease • Oncology • Transplant Rejection • Transplantation

Beyond DSAs: Unraveling the Complexities of Antibody-Mediated Rejection in Kidney Transplants (ERA 2025) - "Induction therapy included basiliximab (51.9%) and thymoglobulin (37%), while 96.3% of patients received tacrolimus, mycophenolate mofetil, and prednisone for maintenance... This study highlights the complexity of AMR in kidney transplantation, showing that DSA presence alone may not predict graft loss or mortality. Microvascular inflammation and other histopathological changes, as well as donor characteristics, also play a significant role in long- term outcomes. Further research is needed to identify additional biomarkers and refine therapeutic strategies, particularly for DSA-negative patients, to improve graft survival and reduce rejection risk."

Antibody-mediated Rejection • Inflammation • Nephrology • Transplantation • HLA-B

A decade of ABO incompatible kidney transplantation: results and lessons learned (ERA 2025) - "Induction immunosuppression consisted of thymoglobulin, prednisone, tacrolimus, and mycophenolic acid... Despite the immunological challenges inherent in ABO-incompatible LDKT, current desensitization protocols allow for acceptable rates of acute rejection and provide satisfactory long-term graft and patient survival."

Antibody-mediated Rejection • Cardiovascular • Hematological Disorders • Infectious Disease • Oncology • Thrombosis • Transplant Rejection • Transplantation

DELISTING STRATEGY IN HIGHLY SENSITISED PATIENTS WITH PREFORMED DSA (ERA 2025) - "In the case group there was greater use of rituximab in induction (p=0.052) and i.v. immunoglobulin plasmapheresis (p=0.005)... Delisting strategies are an option for highly sensitised patients with the presence of DSA, even without the use of imlifidase. The rate of AR and CMV infection was higher, but with acceptable survival data, so they can be considered in situations where the patient's immune status limits access to KT."

Clinical • Antibody-mediated Rejection • Cytomegalovirus Infection • Infectious Disease • Novel Coronavirus Disease • Transplant Rejection

Risk Factors of Mucocutaneous Manifestations in Kidney Transplant Recipients (ERA 2025) - "Induction immunosuppressive therapy included Thymoglobulin in 82% and Basiliximab in 9.4% of cases. Maintenance therapy regimens were: low-dose corticosteroids, tacrolimus, and mycophenolate mofetil (MMF) in 51.8%; low-dose corticosteroids, ciclosporin, and MMF in 12.2%; and other combinations, including azathioprine and sirolimus, in the remaining patients... These findings underscore the importance of regular dermatological monitoring and tailored interventions for kidney transplant recipients, especially those with identified risk factors, to manage and mitigate mucocutaneous complications effectively."

Clinical • Actinic Keratosis • Atopic Dermatitis • Basal Cell Carcinoma • Chronic Kidney Disease • Dermatology • Immunology • Infectious Disease • Kaposi Sarcoma • Non-melanoma Skin Cancer • Oncology • Renal Disease • Sarcoma • Solid Tumor • Squamous Cell Carcinoma • Transplantation

Initial results after the implementation of an immunoguided cytomegalovirus prevention protocol in kidney transplant recipients (ERA 2025) - "From the third month onward, preemptive therapy was also initiated in patients with negative or indeterminate QF-CMV results who had received basiliximab induction... •The use of QF-CMV enables individualized CMV prevention strategies in transplant recipients, reducing exposure to antiviral therapies without increasing the risk of infection. •Further experience with this technique is needed to refine protocols and to consider adjustments to the test's cutoff point to enhance its performance."

Clinical • Cytomegalovirus Infection • Transplantation

THE ROLE OF PROTOCOL BIOPSIES IN KIDNEY TRANSPLANTATION: CLINICAL IMPACT AND PROGNOSTIC VALUE OF BANFF CRITERIA (ERA 2025) - "This study highlights the importance of protocol biopsies in detecting early rejection, particularly in basiliximab- treated patients. Despite being an invasive procedure, its safety was confirmed, with no major complications observed. Early detection of rejection allowed for effective interventions, resulting in long-term improvements in renal function comparable to patients without rejection."

Biopsy • Clinical • Cardiovascular • Fibrosis • Immunology • Inflammation • Transplantation • Vasculitis

COMPARISON OF THYMOGLOBULIN® VS GRAFALON® AS INDUCTION TREATMENT IN KIDNEY TRANSPLANTATION WITH MAASTRICHT TYPE III DONOR (ERA 2025) - "The two most commonly used drugs are Thymoglobulin® and Grafalon®, both rabbit antithymocyte globulins, although they have different antigenic profiles and antibody concentrations. These results suggest that Grafalon® and Thymoglobulin® are comparable in terms of efficacy and safety, with a more favourable haematological profile for Grafalon® in low- immunological-risk KT recipients. However, further studies are needed to confirm these findings."

Cardiovascular • Cytomegalovirus Infection • Infectious Disease • Transplant Rejection • Transplantation

Impact of low dose thymoglobulin-basiliximab induction therapy on acute rejection and post-transplant neoplasia in kidney transplant recipients (ERA 2025) - "Low-dose ATG combined with Basiliximab may serve as an effective and safe induction strategy, significantly reducing acute rejection risk with a minimal increase in infection rates and no added neoplasia risk compared to Basiliximab alone. This approach could be considered for low-risk patients, though further studies are needed to evaluate long-term outcomes."

Clinical • Post-transplantation • Cytomegalovirus Infection • Infectious Disease • Nephrology • Oncology • Transplant Rejection • Transplantation

LESS IS MORE? EVALUATING LOWER THYMOGLOBULIN INDUCTION IN KIDNEY TRANSPLANTATION (ERA 2025) - "Reducing Thymoglobulin induction from 10.5 mg/kg to 6 mg/kg was associated with a lower infection rate and improved renal function at 6 months, despite a higher incidence of acute rejection. However, protocol biopsies enabled early detection and treatment, mitigating its impact on graft function. These findings suggest that a lower Thymoglobulin dose may be a viable strategy to reduce infectious complications while maintaining graft function."

Antibody-mediated Rejection • Cardiovascular • Diabetes • Infectious Disease • Metabolic Disorders • Nephrology • Transplant Rejection • Transplantation

Fludarabine Based RIC for Bone Marrow Failure Syndromes (clinicaltrials.gov) - P1 | N=25 | Recruiting | Sponsor: Children's Hospital of Philadelphia | Trial completion date: Dec 2026 ➔ Dec 2027 | Trial primary completion date: Feb 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Anemia • Aplastic Anemia • Bone Marrow Transplantation • Hematological Disorders • Myelodysplastic Syndrome • Neutropenia • Transplantation

Haploidentical stem cell transplantation in newly diagnosed high-risk neuroblastoma: Results from a single-arm, prospective study from India. (PubMed, Indian J Cancer) - "Children with high-risk neuroblastoma continued to relapse within a year post-HSCT in our cohort. Significant improvement in outcomes was not demonstrated with haploidentical HSCT. We urgently need new strategies including deeper remission induction with upfront metaiodobenzylguanidine (MIBG) therapy followed by HSCT to improve the outcomes."

Journal • Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Neuroblastoma • Oncology • Solid Tumor • Transplantation