Q&A 74: AHSCT with ATG vs AHSCT with rituximab vs alemtuzumab

My recommendation is based on how I think AHSCT and alemtuzumab work. The haemoncologists and my colleagues may disagree with me.

Question

I have the option of having a non-myeloablative autologous haemopoietic stem cell transplant (AHSCT) with no antithymocyte globulin (ATG). I can access a more aggressive HSCT that uses ATG at another centre. Is there any guidance on how to compare efficacy?

What about alemtuzumab (Lemtrada)? It is at least two treatment courses and may be less aggressive. But it does offer less time off work.

What would you recommend?

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Prof G’s answer

Q: I have the option of having a non-myeloablative autologous haemopoietic stem cell transplant (AHSCT) with no antithymocyte globulin (ATG). I can access a more aggressive HSCT that uses ATG at another centre. Is there any guidance on how to compare efficacy?

What about alemtuzumab (Lemtrada)? It is at least two treatment courses and may be less aggressive. But it does offer less time off work.

What would you recommend?

My recommendation is based on how I think AHSCT and alemtuzumab work. The haemoncologists and my colleagues may disagree with me…..