Anti Thymocyte globulin therapy for treatment of Aplastic Anemia- A retrospective Study
Journal Title: International Journal of Medical and Health Sciences - Year 2016, Vol 5, Issue 4
Abstract
Background: Anti thymocyte globulin therapy is considered as standard first line immunosuppressive therapy for patients with acquired aplastic anemia. Aim of this study is to evaluate the response of anti thymocyte globulin (ATG) therapy for treatment of aplastic anemia (AA). Methods and Materials: In this retrospective analysis of 104 aplastic anemia patients. All patients were treated with anti-thymocyte globulin (ATG)(40 mg/kg/day for 4 days) plus Cyclosporin A (CSA) (6 mg/kg/day for 6 months). Blood component support was given up to 3 to 6 months depending on the response and comprehensive measures were provided to prevent treatment-related side effects. Results: Full course of anti-thymocyte globulin (ATG) of 4 days was successfully administered in 103 patients out of 104 patients (age 7-63). At 24 weeks, one patient achieved complete remission(CR) and 50 patients could achieve partial remission(PR). At 24 weeks overall response (OR) was observed in 51 out of 103(49.51%) patients. 44 out of 85 (51.76%) adult patients achieved overall response(OR) at 24 weeks whereas 7 out of 18 (38.88%) pediatric patients could achieve overall response (OR).Relapse of aplastic anemia did not occur in any patient during 6 months. One patient died due to infection on 3rd day. All adverse events were successfully managed symptomatically. Conclusion: Horse Anti-thymocyte globulin and cyclosporine therapy produces response rates around 50% at the end of 6 months. It gives reasonably good response. Anti-thymocyte globulin combined with cyclosporine remains the standard immunosuppressive therapy for transplant ineligible patients of aplastic anemia.
Authors and Affiliations
Rabindra Kumar Jena, Sudha Sethy, Trupti Rekha Swain, Rajeeb Kumar Nayak, Ashutosh Panigrahi
Keywords
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