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Model-based dosing of Anti-Thymocyte Globulin in children

Model-based dosing of anti-thymocyte globulin (ATG), leads to improved T-cell recovery after allogeneic hematopoietic cell transplantation whilst preventing graft-versus-host-disease (GvHD) and graft failure (GF). Compared to traditional fixed dosing of ATG, given close to the graft, model-based dosing shows a benefit in survival. This site gives an overview of all evidence supporting model-based ATG (Thymoglobulin) dosing.

How to implement ATG model-based dosing in your centre

Model-based dosing is easy to implement
The MBD of ATG is very easy to implement. There is no need for local labs measuring ATG concentrations, nor is local knowledge of TDM necessary. Dosing is done using dosing tables*:

* Please note that separate tables are used for either Bone Marrow/Peripheral Blood or for Cord Blood, in which the dose is selected using body weight, lymphocyte counts and stem cell source. The dosing tables are designed for pediatric patients receiving bone marrow, peripheral blood or cord blood transplant (not including haplo-identical settings), receiving myeloablative conditioning.

Support in implementing model-based dosing
We have a support desk for ATG-related questions; we try to answer within 24 hours.
We are happy to help with implementation of model-based dosing in your current clinical practice, and are available for patient-specific questions related to ATG.

Medical Responsibility
The responsibility for the use of the ATG model-based dosing and treatment of the patient lies with the treating physician, which includes informing the patient that prescription of ATG including the model-based ATG dosing, is off-label, including the possible risks and benefits, and relevant authorization from local health authorities as per applicable local laws and regulation.

Background