Anti thymocyte globulin atg

Manufactured by Sanofi

Sourced in France

Anti-thymocyte globulin (ATG) is a polyclonal antibody preparation derived from the serum of animals immunized with human thymocytes. It is used in the management of various medical conditions, including organ transplantation and autoimmune disorders.

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Lab products found in correlation

Belatacept, by Bristol-Myers Squibb (1 mentions) Cobra venom factor, by Complement Technology (1 mentions) Basiliximab, by Novartis (1 mentions)

4 protocols using anti thymocyte globulin atg

Allogeneic HSCT GVHD Prophylaxis Protocol

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All patients received 3 mg/kg/day of cyclosporine A (CsA; Sandoz) intravenously between days -2 to +5 (The transplantation day was assumed as day zero) followed by 12.5 mg/kg/day P.O. for 6 months along with methotrexate (MTX; Sandoz) IV on days +1 (10 mg/kg), +3, +6, and +11 (6 mg/kg) as GVHD prophylaxis. Twenty patients received 2.5 mg/kg of anti-thymocyte globulin (ATG; Genzyme) for 2 days (-1 and -2) in addition to the routine GVHD prophylaxis.
We applied the NCC system for the evaluation of GVHD incidence in allo-HSCT patients (7 (link)). The standard clinical signs, including diarrhea, rash, and abnormalities in liver function tests, along with biopsy and histopathological criteria in the involved organs, were principal manifestations for diagnosis of GVHD. Moreover, the CMV Ag were measured before and after the HSCT using real time PCR detection kit (Dynabio), and positive cases were detected according to the manufacturer’s protocol. All patients with negative CMV Ag and IgM at the admission day underwent HSCT and included to the study.

Mehdizadeh M., Parkhideh S., Salari S., Roshandel E., Kazemi M.H., Bonakchi H., Soleimani M, & Hajifathali A. (2021). Risk Factors of Graft-Versus-Host Disease in the Iranian Allogeneic Hematopoietic Stem Cell Transplantation: A 10-Year Experience. Medical Journal of the Islamic Republic of Iran, 35, 145.

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Multi-modal Induction and Maintenance Immunosuppression

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Induction immunosuppression for all recipients consisted of a single dose of anti-thymocyte globulin (ATG) (10 mg/kg) (Genzyme, Cambridge, MA, USA) on Day −2, as well as Cobra Venom Factor (CVF) (100 ug/kg) (Complement Technology, Tyler, TX, USA) for complement factor (CH50) depletion on Day −1. Maintenance immunosuppression consisted of a continuous tacrolimus (FK-506) infusion (0.20 mg/kg/day; with target serum levels of 10–20 ng/ml) starting on Day −2 and a methylprednisone taper starting on Day 0. Additional maintenance immunosuppression was provided with belatacept for co-stimulation blockade (n = 3) (20 mg/kg on Days −1, 0, 4, 7, 14 and 21, Bristol-Myers Squibb, New York, NY, USA) or anti-CD40 monoclonal antibody (mAb) (n = 1) (20 mg/kg on Days 0 and 5 and 10 mg/kg on Day 7 and weekly thereafter, NHP Reagent Resource, Boston, MA, USA).

Shah J.A., Patel M.S., Elias N., Navarro-Alvarez N., Rosales I., Wilkinson R.A., Louras N.J., Hertl M., Fishman J.A., Colvin R.B., Cosimi A.B., Markmann J.F., Sachs D.H, & Vagefi P.A. (2017). Prolonged Survival Following Pig-to-Primate Liver Xenotransplantation Utilizing Exogenous Coagulation Factors and Co-Stimulation Blockade. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 17(8), 2178-2185.

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Immunosuppression Regimen for SPKT Recipients

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Primary immunosuppression in all SPKT recipients (SPKTR) was based on a triple-drug regimen with tacrolimus (Astellas, Tokyo, Japan), mycophenolate (MPA), either mycophenolate mofetil (MMF) (Roche, Basel, Switzerland) or enteric coated mycophenolic sodium (ECMPS) (Novartis Pharma, Rotkreuz, Switzerland), and steroids. Tacrolimus was initially dosed at 0.15 mg/kg/d, and trough levels were maintained at 8–10 ng/mL for 6 months and at 5–7 ng/mL afterwards. Initial daily MMF dosage was 2 g/day. All SPKTRs received induction therapy with a lymphocyte-depleting agent (antithymocyte globulin (ATG)) (Sanofi-Aventis, Paris, France). In case of contraindications for ATG, an IL-2R antagonist (basiliximab) (Novartis Pharma, Rotkreuz, Switzerland) was used.

Lehner L.J., Öllinger R., Globke B., Naik M.G., Budde K., Pratschke J., Eckardt K.U., Kahl A., Zhang K, & Halleck F. (2021). Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis. Journal of Clinical Medicine, 10(15), 3237.

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Conditioning Regimens for HLA-Matched and Haploidentical HSCT

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The patients undergoing HLA-matched HSCT were conditioned with 9.0–10.5 Gy total-body irradiation (TBI) on days −5 and −4 and 60 mg/kg/day intravenous cyclophosphamide (CY) on days −3 and −2. The patients undergoing haploidentical HSCT were conditioned with 9.0–10.5 Gy TBI on days −7 and −6, 6 g/m²/day intravenous arabinosylcytosine (Ara-C) on days −5 to −3, 45 mg/kg/day intravenous CY on days −3 to −2, and 2.5 mg/kg/day intravenous anti-thymocyte globulin (ATG) (Sanofi, SangStat, Lyon, France) on days −5 to −2.
All of the patients received imatinib prior to transplantation. Imatinib was administered posttransplantation only if BCR-ABL transcripts were detectable by real-time quantitative PCR and if the patients could tolerate oral imatinib without developing gut graft-versus-host disease (GVHD) or life-threatening infection.

Gao L., Zhang C., Gao L., Liu Y., Su Y., Wang S., Li B., Yang T., Yuan Z, & Zhang X. (2015). Favorable outcome of haploidentical hematopoietic stem cell transplantation in Philadelphia chromosome-positive acute lymphoblastic leukemia: a multicenter study in Southwest China. Journal of Hematology & Oncology, 8, 90.

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