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Annals of hematology2010; 89(9); 851-859; doi: 10.1007/s00277-010-0944-y

Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia: a single-center retrospective study.

Abstract: The best antithymocyte globulin preparation for first-line immune suppression in patients with severe aplastic anemia is still not clear. The aim of this study was to compare hematological response and overall survival in patients submitted to horse or rabbit antithymocyte globulin as first-line treatment for severe aplastic anemia. We retrospectively compared 71 consecutive patients with severe aplastic anemia, classified according to the antithymocyte globulin preparation. Analyses included variables related to patients and to immune suppression. Forty two patients (59.1%) received horse and 29 (40.9%) rabbit antithymocyte globulin. Response rates were higher at 6 months in patients submitted to horse in comparison to rabbit antithymocyte globulin (59.5% versus 34.5% respectively, p = 0.05). Median time to response was similar between the two groups (99 versus 88.5 days, respectively, for horse and rabbit antithymocyte globulin; p = 0.98). Overall survival at 2 years was significantly higher in patients submitted to horse in comparison to rabbit antithymocyte globulin (78.4% versus 55.4%, p = 0.03). Post-treatment response was strongly associated with survival at 2 years (97% in responders versus 41.2% in non-responders, p < 0.001). Use of rabbit antithymocyte globulin was an independent predictor of death (odds ratio 2.5; 95% confidence interval 1.03-6.04; p = 0.04). Rabbit antithymocyte globulin was associated with a significant and prolonged lymphopenia in comparison with horse antithymocyte globulin. Our data suggest the superiority of horse over rabbit antithymocyte globulin as first-line treatment for severe aplastic anemia, both regarding hematological response and survival.
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Publication Date: 2010-04-07 PubMed ID: 20373101DOI: 10.1007/s00277-010-0944-yGoogle Scholar: Lookup
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  • Comparative Study
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study compares the efficacy of horse and rabbit antithymocyte globulin as a first-line therapy for severe aplastic anemia, finding that treatment with horse globulin showed higher response rates and survival rates at 2-year mark.

Background

  • The study was conducted to determine the most effective form of antithymocyte globulin for immune suppression in patients suffering from severe aplastic anemia.

Methodology

  • The research retrospectively compared 71 patients with severe aplastic anemia who have been treated either with horse or rabbit antithymocyte globulin.
  • The variables studied included factors related to the patients and also to the immune suppression.

Findings

  • Out of total participants, 59.1% were treated with horse globulin and 40.9% with rabbit globulin.
  • Patients who were given horse globulin demonstrated higher response rates at 6-month period when compared to those who were given rabbit globulin (59.5% versus 34.5%).
  • The median time to response was found to be similar in both the groups (99 and 88.5 days for horse and rabbit globulin respectively).
  • Overall survival at 2 years was significantly higher in the horse globulin patients in comparison to the rabbit globulin ones (78.4% versus 55.4%).

Conclusion

  • Post-treatment response was strongly related to 2-year survival rates, with 97% among responders versus 41.2% in non-responders.
  • Rabbit globulin usage was independently linked to higher mortality rates (odds ratio 2.5).
  • Rabbit globulin was associated with a significant and prolonged lymphopenia when compared to horse globulin.
  • The data from the research suggests that horse antithymocyte globulin may be superior to rabbit globulin as the first-line treatment for severe aplastic anemia, both in terms of hematological response and survival.

Cite This Article

APA
Atta EH, Dias DS, Marra VL, de Azevedo AM. (2010). Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia: a single-center retrospective study. Ann Hematol, 89(9), 851-859. https://doi.org/10.1007/s00277-010-0944-y

Publication

Annals of hematology
ISSN: 1432-0584
NlmUniqueID: 9107334
Country: Germany
Language: English
Volume: 89
Issue: 9
Pages: 851-859

Researcher Affiliations

Atta, Elias Hallack
  • Hematopoietic Stem Cell Program, Hemorio, Rua Frei Caneca 8, Rio de Janeiro, RJ, Brazil. elias.atta@hemorio.rj.gov.br
Dias, Danielle Saldanha Peixoto
    Marra, Vera Lúcia Neves
      de Azevedo, Alexandre Mello

        MeSH Terms

        • Adolescent
        • Adult
        • Aged
        • Anemia, Aplastic / drug therapy
        • Anemia, Aplastic / mortality
        • Animals
        • Antilymphocyte Serum / adverse effects
        • Antilymphocyte Serum / therapeutic use
        • Child
        • Child, Preschool
        • Female
        • Horses
        • Humans
        • Infant
        • Lymphopenia / chemically induced
        • Male
        • Middle Aged
        • Rabbits
        • Retrospective Studies
        • Severity of Illness Index
        • Species Specificity
        • Survival Rate / trends
        • T-Lymphocytes / immunology
        • Treatment Outcome
        • Young Adult

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