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Home / Equine Research Bank / Haematologica / Efficacy of rabbit anti-thymocyte globulin in severe aplasti...
Haematologica2011; 96(9); 1269-1275; doi: 10.3324/haematol.2011.042622

Efficacy of rabbit anti-thymocyte globulin in severe aplastic anemia.

Abstract: A combination of horse anti-thymocyte globulin and cyclosporine produces responses in 60-70% of patients with severe aplastic anemia. We performed a phase II study of rabbit anti-thymocyte globulin and cyclosporine as first-line therapy for severe aplastic anemia. Methods: Twenty patients with severe aplastic anemia treated with rabbit anti-thymocyte globulin were compared to 67 historical control cases with matched clinical characteristics treated with horse anti-thymocyte globulin. Results: Response rates at 3, 6 and 12 months were similar for patients treated with rabbit anti-thymocyte globulin or horse anti-thymocyte globulin: 40% versus 55% (P=0.43), 45% versus 58% (P=0.44) and 50% versus 58% (P=0.61), respectively. No differences in early mortality rates or overall survival were observed. We then performed multivariable analyses of response at 6 months and overall survival and identified the presence of a paroxysmal nocturnal hemoglobinuria clone (P=0.01) and a pretreatment absolute reticulocyte count greater than 30×10(9)/L (P=0.007) as independent predictors of response and younger age (P=0.003), higher pretreatment absolute neutrophil (P=0.02) and absolute lymphocyte counts (P=0.03) as independent predictors of overall survival. None of the immunogenetic polymorphisms studied was predictive of response to immunosupressive therapy. Conclusions: Despite reports suggesting differences in biological activity of different anti-thymocyte globulin preparations, rabbit and horse anti-thymocyte globulin appear to have a similar efficacy for up-front treatment of severe aplastic anemia. Clinicaltrial.gov: NCT01231841).
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Publication Date: 2011-05-23 PubMed ID: 21606164PubMed Central: PMC3166096DOI: 10.3324/haematol.2011.042622Google Scholar: Lookup
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  • Clinical Trial
  • Phase II
  • Journal Article
  • Research Support
  • N.I.H.
  • Extramural
  • Research Support
  • Non-U.S. Gov't

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 studied whether rabbit anti-thymocyte globulin combined with cyclosporine is an effective first-line therapy for severe aplastic anemia. It found no significant differences in patient response or survival rates when comparing this to the standard treatment of horse anti-thymocyte globulin combined with cyclosporine.

Research Methodology

  • The research used a phase II study, a kind of trial used to see if a treatment works in people who have a certain disease or condition. Here, they tested a combination of rabbit anti-thymocyte globulin and cyclosporine as first-line therapy for severe aplastic anemia.
  • Twenty patients with severe aplastic anemia were administered the rabbit anti-thymocyte globulin treatment and were then compared to 67 historical control cases who shared similar characteristics but were given horse anti-thymocyte globulin treatment.

Research Findings

  • Researchers observed response rates and overall survival at 3, 6, and 12 months between both groups of patients after treatment. The results showed that there were no significant differences in response rates or early mortality rates between the group treated with rabbit anti-thymocyte globulin and the group treated with horse anti-thymocyte globulin.
  • They then conducted a multi-variable analysis of the 6-month response and overall survival rates and found that certain factors were independent predictors of response and survival. These included the presence of a paroxysmal nocturnal hemoglobinuria clone, the pretreatment absolute reticulocyte count, the age of the patient, the pretreatment absolute neutrophil, and absolute lymphocyte counts.
  • Immunogenetic polymorphisms studied in the patients were found to not be predictive of response to immunosuppressive therapy.

Research Conclusions

  • The findings concluded that despite preliminary reports that there may be different benefits between the different globulin preparations, the efficacy of rabbit and horse anti-thymocyte globulin seems to be similar for the upfront treatment of severe aplastic anemia.
  • This conclusion suggests that the type of globulin preparation may not be a decisive factor in determining the success of therapy for severe aplastic anemia.

Cite This Article

APA
Afable MG, Shaik M, Sugimoto Y, Elson P, Clemente M, Makishima H, Sekeres MA, Lichtin A, Advani A, Kalaycio M, Tiu RV, O'Keefe CL, Maciejewski JP. (2011). Efficacy of rabbit anti-thymocyte globulin in severe aplastic anemia. Haematologica, 96(9), 1269-1275. https://doi.org/10.3324/haematol.2011.042622

Publication

Haematologica
ISSN: 1592-8721
NlmUniqueID: 0417435
Country: Italy
Language: English
Volume: 96
Issue: 9
Pages: 1269-1275

Researcher Affiliations

Afable, Manuel G
  • Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Shaik, Mohammed
    Sugimoto, Yuka
      Elson, Paul
        Clemente, Michael
          Makishima, Hideki
            Sekeres, Mikkael A
              Lichtin, Alan
                Advani, Anjali
                  Kalaycio, Matt
                    Tiu, Ramon V
                      O'Keefe, Christine L
                        Maciejewski, Jaroslaw P

                          MeSH Terms

                          • Adolescent
                          • Adult
                          • Aged
                          • Aged, 80 and over
                          • Anemia, Aplastic / drug therapy
                          • Anemia, Aplastic / genetics
                          • Anemia, Aplastic / mortality
                          • Animals
                          • Antilymphocyte Serum / administration & dosage
                          • Antilymphocyte Serum / adverse effects
                          • Antilymphocyte Serum / therapeutic use
                          • Child
                          • Child, Preschool
                          • Cyclosporine / therapeutic use
                          • Cytokines / genetics
                          • Female
                          • Horses
                          • Humans
                          • Immunosuppressive Agents / therapeutic use
                          • Male
                          • Middle Aged
                          • Polymorphism, Genetic
                          • Rabbits
                          • Recurrence
                          • Survival Analysis
                          • Treatment Outcome
                          • Young Adult

                          Grant Funding

                          • K24 HL077522 / NHLBI NIH HHS
                          • R01 AI085578 / NIAID NIH HHS
                          • U54 RR019397 / NCRR NIH HHS
                          • R01AI-85578 / NIAID NIH HHS

                          References

                          This article includes 36 references
                          1. Young NS, Calado RT, Scheinberg P. Current concepts in the pathophysiology and treatment of aplastic anemia.. Blood 2006 Oct 15;108(8):2509-19.
                            pmc: PMC1895575pubmed: 16778145doi: 10.1182/blood-2006-03-010777google scholar: lookup
                          2. Frickhofen N, Kaltwasser JP, Schrezenmeier H, Raghavachar A, Vogt HG, Herrmann F, Freund M, Meusers P, Salama A, Heimpel H. Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. The German Aplastic Anemia Study Group.. N Engl J Med 1991 May 9;324(19):1297-304.
                            pubmed: 2017225doi: 10.1056/nejm199105093241901google scholar: lookup
                          3. Frickhofen N, Heimpel H, Kaltwasser JP, Schrezenmeier H. Antithymocyte globulin with or without cyclosporin A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia.. Blood 2003 Feb 15;101(4):1236-42.
                            pubmed: 12393680doi: 10.1182/blood-2002-04-1134google scholar: lookup
                          4. Rosenfeld S, Follmann D, Nunez O, Young NS. Antithymocyte globulin and cyclosporine for severe aplastic anemia: association between hematologic response and long-term outcome.. JAMA 2003 Mar 5;289(9):1130-5.
                            pubmed: 12622583doi: 10.1001/jama.289.9.1130google scholar: lookup
                          5. Locasciulli A, Oneto R, Bacigalupo A, Socié G, Korthof E, Bekassy A, Schrezenmeier H, Passweg J, Führer M. Outcome of patients with acquired aplastic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the European Group for Blood and Marrow Transplantation (EBMT).. Haematologica 2007 Jan;92(1):11-8.
                            pubmed: 17229630doi: 10.3324/haematol.10075google scholar: lookup
                          6. Scheinberg P, Fischer SH, Li L, Nunez O, Wu CO, Sloand EM, Cohen JI, Young NS, John Barrett A. Distinct EBV and CMV reactivation patterns following antibody-based immunosuppressive regimens in patients with severe aplastic anemia.. Blood 2007 Apr 15;109(8):3219-24.
                            pmc: PMC1852232pubmed: 17148582doi: 10.1182/blood-2006-09-045625google scholar: lookup
                          7. Fehérvari Z, Sakaguchi S. CD4+ Tregs and immune control.. J Clin Invest 2004 Nov;114(9):1209-17.
                            pmc: PMC524236pubmed: 15520849doi: 10.1172/jci23395google scholar: lookup
                          8. Chen G, Kook H, Zeng W, Young NS, Maciejewski JP. Is there a direct effect of antithymocyte globulin on hematopoiesis?. Hematol J 2004;5(3):255-61.
                            pubmed: 15167913doi: 10.1038/sj.thj.6200398google scholar: lookup
                          9. Flynn J, Cox CV, Rizzo S, Foukaneli T, Rice K, Murphy M, Welsh J, Rutherford TR, Gordon-Smith EC, Gibson FM. Direct binding of antithymoctye globulin to haemopoietic progenitor cells in aplastic anaemia.. Br J Haematol 2003 Jul;122(2):289-97.
                            pubmed: 12846899doi: 10.1046/j.1365-2141.2003.04400.xgoogle scholar: lookup
                          10. Killick SB, Cox CV, Marsh JC, Gordon-Smith EC, Gibson FM. Mechanisms of bone marrow progenitor cell apoptosis in aplastic anaemia and the effect of anti-thymocyte globulin: examination of the role of the Fas-Fas-L interaction.. Br J Haematol 2000 Dec;111(4):1164-9.
                            pubmed: 11167757doi: 10.1046/j.1365-2141.2000.02485.xgoogle scholar: lookup
                          11. Feng X, Kajigaya S, Solomou EE, Keyvanfar K, Xu X, Raghavachari N, Munson PJ, Herndon TM, Chen J, Young NS. Rabbit ATG but not horse ATG promotes expansion of functional CD4+CD25highFOXP3+ regulatory T cells in vitro.. Blood 2008 Apr 1;111(7):3675-83.
                            pmc: PMC2275026pubmed: 18250226doi: 10.1182/blood-2008-01-130146google scholar: lookup
                          12. Di Bona E, Rodeghiero F, Bruno B, Gabbas A, Foa P, Locasciulli A, Rosanelli C, Camba L, Saracco P, Lippi A, Iori AP, Porta F, De Rossi G, Comotti B, Iacopino P, Dufour C, Bacigalupo A. Rabbit antithymocyte globulin (r-ATG) plus cyclosporine and granulocyte colony stimulating factor is an effective treatment for aplastic anaemia patients unresponsive to a first course of intensive immunosuppressive therapy. Gruppo Italiano Trapianto di Midollo Osseo (GITMO).. Br J Haematol 1999 Nov;107(2):330-4.
                            pubmed: 10583220doi: 10.1046/j.1365-2141.1999.01693.xgoogle scholar: lookup
                          13. Scheinberg P, Nunez O, Young NS. Retreatment with rabbit anti-thymocyte globulin and ciclosporin for patients with relapsed or refractory severe aplastic anaemia.. Br J Haematol 2006 Jun;133(6):622-7.
                            pubmed: 16704436doi: 10.1111/j.1365-2141.2006.06098.xgoogle scholar: lookup
                          14. Kadia T, Ravandi F, Garcia-Manero G, Jabbour E, Borthakur G, Estrov Z. Updated results of combination cytokine immunotherapy in the treatment of aplastic anemia and myelodysplastic syndrome (MDS). Blood 2010;116(22):4422–9.
                            pubmed: 0
                          15. Vallejo C, Montesinos P, Rosell A, Brunet S, Perez E, Petit J. Comparison between lymphoglobuline- and thymoglobuline-based immunosuppressive therapy as a first-line treatment for patients with aplastic anemia. Haematologica 2009;94(S. 2):451.
                            pubmed: 0
                          16. Zheng Y, Liu Y, Chu Y. Immunosuppressive therapy for acquired severe aplastic anemia (SAA): a prospective comparison of four different regimens.. Exp Hematol 2006 Jul;34(7):826-31.
                            pubmed: 16797409doi: 10.1016/j.exphem.2006.03.017google scholar: lookup
                          17. Atta EH, Dias DS, Marra VL, de Azevedo AM. Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia: a single-center retrospective study.. Ann Hematol 2010 Sep;89(9):851-9.
                            pubmed: 20373101doi: 10.1007/s00277-010-0944-ygoogle scholar: lookup
                          18. Maschan MA, Novichkova G, Baidildina D, Suntzova E, Kravchenko E, Goronkova O. Horse ATG (ATGAM) versus rabbit ATG (Fresenius) for treatment of aplastic anemia in children: results of prospective double-blind randomised single centre trial. Bone Marrow Transplant 2004;33:S3–S79.
                          19. Scheinberg P, Wu CO, Nunez O, Young NS. Predicting response to immunosuppressive therapy and survival in severe aplastic anaemia.. Br J Haematol 2009 Jan;144(2):206-16.
                            pmc: PMC4149225pubmed: 19036108doi: 10.1111/j.1365-2141.2008.07450.xgoogle scholar: lookup
                          20. Maciejewski JP, Rivera C, Kook H, Dunn D, Young NS. Relationship between bone marrow failure syndromes and the presence of glycophosphatidyl inositol-anchored protein-deficient clones.. Br J Haematol 2001 Dec;115(4):1015-22.
                            pubmed: 11843844doi: 10.1046/j.1365-2141.2001.03191.xgoogle scholar: lookup
                          21. Mohan SR, Clemente MJ, Afable M, Cazzolli HN, Bejanyan N, Wlodarski MW, Lichtin AE, Maciejewski JP. Therapeutic implications of variable expression of CD52 on clonal cytotoxic T cells in CD8+ large granular lymphocyte leukemia.. Haematologica 2009 Oct;94(10):1407-14.
                            pmc: PMC2754957pubmed: 19794084doi: 10.3324/haematol.2009.009191google scholar: lookup
                          22. Wlodarski MW, Gondek LP, Nearman ZP, Plasilova M, Kalaycio M, Hsi ED, Maciejewski JP. Molecular strategies for detection and quantitation of clonal cytotoxic T-cell responses in aplastic anemia and myelodysplastic syndrome.. Blood 2006 Oct 15;108(8):2632-41.
                            pmc: PMC1895579pubmed: 16614248doi: 10.1182/blood-2005-09-3902google scholar: lookup
                          23. Garg R, Faderl S, Garcia-Manero G, Cortes J, Koller C, Huang X, York S, Pierce S, Brandt M, Beran M, Borthakur G, Kantarjian H, Ravandi F. Phase II study of rabbit anti-thymocyte globulin, cyclosporine and granulocyte colony-stimulating factor in patients with aplastic anemia and myelodysplastic syndrome.. Leukemia 2009 Jul;23(7):1297-302.
                            pmc: PMC4217203pubmed: 19242494doi: 10.1038/leu.2009.28google scholar: lookup
                          24. Scheinberg P, Wu C, Scheinberg P, Weinstein B, Nunez O, Sload E, Young N. A randomized trial of horse versus rabbit antithymocyte globulin in severe acquired aplastic anemia. Blood (ASH Annual Meeting Abstracts) 2010 Abstract LBA-4.
                          25. Yazji S, Giles FJ, Tsimberidou AM, Estey EH, Kantarjian HM, O'Brien SA, Kurzrock R. Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes.. Leukemia 2003 Nov;17(11):2101-6.
                            pubmed: 12931212doi: 10.1038/sj.leu.2403124google scholar: lookup
                          26. Molldrem JJ, Caples M, Mavroudis D, Plante M, Young NS, Barrett AJ. Antithymocyte globulin for patients with myelodysplastic syndrome.. Br J Haematol 1997 Dec;99(3):699-705.
                            pubmed: 9401087doi: 10.1046/j.1365-2141.1997.4423249.xgoogle scholar: lookup
                          27. Killick SB, Mufti G, Cavenagh JD, Mijovic A, Peacock JL, Gordon-Smith EC, Bowen DT, Marsh JC. A pilot study of antithymocyte globulin (ATG) in the treatment of patients with 'low-risk' myelodysplasia.. Br J Haematol 2003 Feb;120(4):679-84.
                            pubmed: 12588356doi: 10.1046/j.1365-2141.2003.04136.xgoogle scholar: lookup
                          28. Stadler M, Germing U, Kliche KO, Josten KM, Kuse R, Hofmann WK, Schrezenmeier H, Novotny J, Anders O, Eimermacher H, Verbeek W, Kreipe HH, Heimpel H, Aul C, Ganser A. A prospective, randomised, phase II study of horse antithymocyte globulin vs rabbit antithymocyte globulin as immune-modulating therapy in patients with low-risk myelodysplastic syndromes.. Leukemia 2004 Mar;18(3):460-5.
                            pubmed: 14712285doi: 10.1038/sj.leu.2403239google scholar: lookup
                          29. Sugimori C, Chuhjo T, Feng X, Yamazaki H, Takami A, Teramura M, Mizoguchi H, Omine M, Nakao S. Minor population of CD55-CD59- blood cells predicts response to immunosuppressive therapy and prognosis in patients with aplastic anemia.. Blood 2006 Feb 15;107(4):1308-14.
                            pubmed: 16179371doi: 10.1182/blood-2005-06-2485google scholar: lookup
                          30. Chang MH, Kim KH, Kim HS, Jun HJ, Kim DH, Jang JH, Kim K, Jung CW. Predictors of response to immunosuppressive therapy with antithymocyte globulin and cyclosporine and prognostic factors for survival in patients with severe aplastic anemia.. Eur J Haematol 2010 Feb 1;84(2):154-9.
                            pubmed: 19912311doi: 10.1111/j.1600-0609.2009.01378.xgoogle scholar: lookup
                          31. Maciejewski JP, Follmann D, Nakamura R, Saunthararajah Y, Rivera CE, Simonis T, Brown KE, Barrett JA, Young NS. Increased frequency of HLA-DR2 in patients with paroxysmal nocturnal hemoglobinuria and the PNH/aplastic anemia syndrome.. Blood 2001 Dec 15;98(13):3513-9.
                            pubmed: 11739151doi: 10.1182/blood.v98.13.3513google scholar: lookup
                          32. Saunthararajah Y, Nakamura R, Nam JM, Robyn J, Loberiza F, Maciejewski JP, Simonis T, Molldrem J, Young NS, Barrett AJ. HLA-DR15 (DR2) is overrepresented in myelodysplastic syndrome and aplastic anemia and predicts a response to immunosuppression in myelodysplastic syndrome.. Blood 2002 Sep 1;100(5):1570-4.
                            pubmed: 12176872
                          33. Young NS, Maciejewski J. The pathophysiology of acquired aplastic anemia.. N Engl J Med 1997 May 8;336(19):1365-72.
                            pubmed: 9134878doi: 10.1056/nejm199705083361906google scholar: lookup
                          34. Demeter J, Messer G, Schrezenmeier H. Clinical relevance of the TNF-alpha promoter/enhancer polymorphism in patients with aplastic anemia.. Ann Hematol 2002 Oct;81(10):566-9.
                            pubmed: 12424537doi: 10.1007/s00277-002-0544-6google scholar: lookup
                          35. Fermo E, Bianchi P, Barcellini W, Pedotti P, Boschetti C, Alfinito F, Cortelezzi A, Zanella A. Immunoregulatory cytokine polymorphisms in Italian patients affected by paroxysmal nocturnal haemoglobinuria and aplastic anaemia.. Eur J Immunogenet 2004 Dec;31(6):267-9.
                            pubmed: 15548264doi: 10.1111/j.1365-2370.2004.00480.xgoogle scholar: lookup
                          36. Hertenstein B, Wagner B, Bunjes D, Duncker C, Raghavachar A, Arnold R, Heimpel H, Schrezenmeier H. Emergence of CD52-, phosphatidylinositolglycan-anchor-deficient T lymphocytes after in vivo application of Campath-1H for refractory B-cell non-Hodgkin lymphoma.. Blood 1995 Aug 15;86(4):1487-92.
                            pubmed: 7632956

                          Citations

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                          1. Wang T, Wang C, Liu C, Shao Z, Fu R. Partial SAA patients benefit from delayed response of IST.. Front Immunol 2023;14:1067977.
                            doi: 10.3389/fimmu.2023.1067977pubmed: 36845107google scholar: lookup
                          2. Yang W, Liu X, Zhao X, Zhang L, Peng G, Ye L, Zhou K, Li Y, Li J, Fan H, Yang Y, Xiong Y, Jing L, Zhang F. Antihuman T lymphocyte porcine immunoglobulin combined with cyclosporine as first-line immunosuppressive therapy for severe aplastic anemia in China: a large single-center, 10-year retrospective study.. Ther Adv Hematol 2023;14:20406207221146031.
                            doi: 10.1177/20406207221146031pubmed: 36654738google scholar: lookup
                          3. Liu L, Miao M, He H, Wang S, Zhang Y, Guo A, Jiao W, Lei M, Cai Y, Shangguan X, Liu Z, Xu J, Li X, Zhang L, Wu D. Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study.. Front Immunol 2022;13:955095.
                            doi: 10.3389/fimmu.2022.955095pubmed: 36131940google scholar: lookup
                          4. Hu XR, Zhao X, Zhang L, Jing LP, Yang WR, Li Y, Ye L, Zhou K, Li JP, Peng GX, Fan HH, Li Y, Yang Y, Xiong YZ, Zhang FK. [Reassessing the six months prognosis of patients with severe or very severe aplastic anemia without hematological responses at three months after immunosuppressive therapy].. Zhonghua Xue Ye Xue Za Zhi 2022 May 14;43(5):393-399.
                            doi: 10.3760/cma.j.issn.0253-2727.2022.05.008pubmed: 35680597google scholar: lookup
                          5. Tjon JM, Langemeijer SMC, Halkes CJM. Anti Thymocyte Globulin-Based Treatment for Acquired Bone Marrow Failure in Adults.. Cells 2021 Oct 27;10(11).
                            doi: 10.3390/cells10112905pubmed: 34831130google scholar: lookup
                          6. Liu L, Zhao X, Miao M, Zhang Y, Jiao W, Lei M, Zhou H, Wang Q, Cai Y, Zhao L, Shangguan X, Liu Z, Xu J, Zhang F, Wu D. Inefficacy of Immunosuppressive Therapy for Severe Aplastic Anemia Progressing From Non-SAA: Improved Outcome After Allogeneic Hematopoietic Stem Cell Transplantation.. Front Oncol 2021;11:739561.
                            doi: 10.3389/fonc.2021.739561pubmed: 34621679google scholar: lookup
                          7. Zaimoku Y, Patel BA, Shalhoub R, Groarke EM, Feng X, Wu CO, Young NS. Predicting response of severe aplastic anemia to immunosuppression combined with eltrombopag.. Haematologica 2022 Jan 1;107(1):126-133.
                            doi: 10.3324/haematol.2021.278413pubmed: 33910334google scholar: lookup
                          8. Liu L, Zhang Y, Jiao W, Zhou H, Wang Q, Jin S, Cai Y, Zhao L, Shangguan X, Liu Z, Xu J, Lei M, Yan X, Miao M, Wu D. Comparison of efficacy and health-related quality of life of first-line haploidentical hematopoietic stem cell transplantation with unrelated cord blood infusion and first-line immunosuppressive therapy for acquired severe aplastic anemia.. Leukemia 2020 Dec;34(12):3359-3369.
                            doi: 10.1038/s41375-020-0933-7pubmed: 32591644google scholar: lookup
                          9. Shah S, Jain P, Shah K, Patel K, Parikh S, Patel A, Panchal H, Anand A. Immunosuppressive therapy for aplastic anemia: a single-center experience from western India.. Ann Hematol 2019 Jan;98(1):41-46.
                            doi: 10.1007/s00277-018-3487-2pubmed: 30173288google scholar: lookup
                          10. Alzahrani N, Ashor N, Fathi T, Bukhari D, Zaher G. Idiopathic severe aplastic anemia with a delayed response to immunosuppressive therapy: a case report.. Clin Case Rep 2018 Jun;6(6):1029-1032.
                            doi: 10.1002/ccr3.1517pubmed: 29881557google scholar: lookup
                          11. Vaht K, Göransson M, Carlson K, Isaksson C, Lenhoff S, Sandstedt A, Uggla B, Winiarski J, Ljungman P, Brune M, Andersson PO. Incidence and outcome of acquired aplastic anemia: real-world data from patients diagnosed in Sweden from 2000-2011.. Haematologica 2017 Oct;102(10):1683-1690.
                            doi: 10.3324/haematol.2017.169862pubmed: 28751565google scholar: lookup
                          12. Kekre N, Zhang Y, Zhang MJ, Carreras J, Ahmed P, Anderlini P, Atta EH, Ayas M, Boelens JJ, Bonfim C, Deeg HJ, Kapoor N, Lee JW, Nakamura R, Pulsipher MA, Eapen M, Antin JH. Effect of antithymocyte globulin source on outcomes of bone marrow transplantation for severe aplastic anemia.. Haematologica 2017 Jul;102(7):1291-1298.
                            doi: 10.3324/haematol.2017.164459pubmed: 28341733google scholar: lookup
                          13. Hayakawa J, Kanda J, Akahoshi Y, Harada N, Kameda K, Ugai T, Wada H, Ishihara Y, Kawamura K, Sakamoto K, Ashizawa M, Sato M, Terasako-Saito K, Kimura SI, Kikuchi M, Yamazaki R, Kako S, Kanda Y. Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia.. Int J Hematol 2017 May;105(5):578-586.
                            doi: 10.1007/s12185-017-2179-3pubmed: 28078653google scholar: lookup
                          14. Chuncharunee S, Wong R, Rojnuckarin P, Chang CS, Chang KM, Lu MY, Hwang WL, Koh LP, Chen TY, Leung AY, Norasetthada L, Wang SC, Chang MC, Wu KH, Issaragrisil S. Efficacy of rabbit antithymocyte globulin as first-line treatment of severe aplastic anemia: an Asian multicenter retrospective study.. Int J Hematol 2016 Oct;104(4):454-61.
                            doi: 10.1007/s12185-016-2053-8pubmed: 27376944google scholar: lookup
                          15. Suzuki T, Kobayashi H, Kawasaki Y, Okazuka K, Hatano K, Fujiwara S, Oh I, Ohmine K, Kanda Y. Efficacy of combination therapy with anti-thymocyte globulin and cyclosporine A as a first-line treatment in adult patients with aplastic anemia: a comparison of rabbit and horse formulations.. Int J Hematol 2016 Oct;104(4):446-53.
                            doi: 10.1007/s12185-016-2046-7pubmed: 27338268google scholar: lookup
                          16. Narita A, Kojima S. Biomarkers for predicting clinical response to immunosuppressive therapy in aplastic anemia.. Int J Hematol 2016 Aug;104(2):153-8.
                            doi: 10.1007/s12185-016-2009-zpubmed: 27091471google scholar: lookup
                          17. Zhang J, Li X, Shi J, Ge M, Shao Y, Huang J, Huang Z, Nie N, Zheng Y. [Clinical characteristics and evolution of paroxysmal nocturnal hemoglobinuria clones in patients with acquired aplastic anemia].. Zhonghua Xue Ye Xue Za Zhi 2016 Feb;37(2):124-9.
                            doi: 10.3760/cma.j.issn.0253-2727.2016.02.008pubmed: 27014982google scholar: lookup
                          18. Eylem E, Yahya B, Ozlen B, Umit M, Gursel G, Ayse I, Haluk D, Salih A, Hakan G, Nilgun S, Ibrahim H, Osman O. Not all anti-T lymphocyte globulin preparations are suitable for use in aplastic anemia: significantly inferior results with jurkat cell-reactive anti-T lymphocyte globulin in clinical practice.. Int J Clin Exp Med 2015;8(9):16334-9.
                            pubmed: 26629153
                          19. Yang L, Wang H, Shao Z. [Advances in the treatment of severe aplastic anemia].. Zhonghua Xue Ye Xue Za Zhi 2015 Aug;36(8):711-5.
                            doi: 10.3760/cma.j.issn.0253-2727.2015.08.021pubmed: 26462649google scholar: lookup
                          20. Narita A, Muramatsu H, Sekiya Y, Okuno Y, Sakaguchi H, Nishio N, Yoshida N, Wang X, Xu Y, Kawashima N, Doisaki S, Hama A, Takahashi Y, Kudo K, Moritake H, Kobayashi M, Kobayashi R, Ito E, Yabe H, Ohga S, Ohara A, Kojima S. Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia.. Haematologica 2015 Dec;100(12):1546-52.
                            doi: 10.3324/haematol.2015.132530pubmed: 26315930google scholar: lookup
                          21. Shin SH, Lee SE, Lee JW. Recent advances in treatment of aplastic anemia.. Korean J Intern Med 2014 Nov;29(6):713-26.
                            doi: 10.3904/kjim.2014.29.6.713pubmed: 25378968google scholar: lookup
                          22. Yoshida N, Kobayashi R, Yabe H, Kosaka Y, Yagasaki H, Watanabe K, Kudo K, Morimoto A, Ohga S, Muramatsu H, Takahashi Y, Kato K, Suzuki R, Ohara A, Kojima S. First-line treatment for severe aplastic anemia in children: bone marrow transplantation from a matched family donor versus immunosuppressive therapy.. Haematologica 2014 Dec;99(12):1784-91.
                            doi: 10.3324/haematol.2014.109355pubmed: 25193958google scholar: lookup
                          23. Mohty M, Bacigalupo A, Saliba F, Zuckermann A, Morelon E, Lebranchu Y. New directions for rabbit antithymocyte globulin (Thymoglobulin(®)) in solid organ transplants, stem cell transplants and autoimmunity.. Drugs 2014 Sep;74(14):1605-34.
                            doi: 10.1007/s40265-014-0277-6pubmed: 25164240google scholar: lookup
                          24. Samarasinghe S, Marsh J, Dufour C. Immune suppression for childhood acquired aplastic anemia and myelodysplastic syndrome: where next?. Haematologica 2014 Apr;99(4):597-9.
                            doi: 10.3324/haematol.2014.105569pubmed: 24688105google scholar: lookup
                          25. Desmond R, Townsley DM, Dumitriu B, Olnes MJ, Scheinberg P, Bevans M, Parikh AR, Broder K, Calvo KR, Wu CO, Young NS, Dunbar CE. Eltrombopag restores trilineage hematopoiesis in refractory severe aplastic anemia that can be sustained on discontinuation of drug.. Blood 2014 Mar 20;123(12):1818-25.
                            doi: 10.1182/blood-2013-10-534743pubmed: 24345753google scholar: lookup
                          26. Jeong DC, Chung NG, Cho B, Zou Y, Ruan M, Takahashi Y, Muramatsu H, Ohara A, Kosaka Y, Yang W, Kim HK, Zhu X, Kojima S. Long-term outcome after immunosuppressive therapy with horse or rabbit antithymocyte globulin and cyclosporine for severe aplastic anemia in children.. Haematologica 2014 Apr;99(4):664-71.
                            doi: 10.3324/haematol.2013.089268pubmed: 24213150google scholar: lookup
                          27. Weston W, Gupta V, Adkins R, Jurecic R. New therapeutic approaches for protecting hematopoietic stem cells in aplastic anemia.. Immunol Res 2013 Dec;57(1-3):34-43.
                            doi: 10.1007/s12026-013-8449-0pubmed: 24203441google scholar: lookup
                          28. Yoshimi A, van den Heuvel-Eibrink MM, Baumann I, Schwarz S, Simonitsch-Klupp I, de Paepe P, Campr V, Kerndrup GB, O'Sullivan M, Devito R, Leguit R, Hernandez M, Dworzak M, de Moerloose B, Stary J, Hasle H, Smith OP, Zecca M, Catala A, Schmugge M, Locatelli F, Führer M, Fischer A, Guderle A, Nöllke P, Strahm B, Niemeyer CM. Comparison of horse and rabbit antithymocyte globulin in immunosuppressive therapy for refractory cytopenia of childhood.. Haematologica 2014 Apr;99(4):656-63.
                            doi: 10.3324/haematol.2013.095786pubmed: 24162791google scholar: lookup
                          29. Sakamoto T, Obara N, Kurita N, Sakata-Yanagimoto M, Nishikii H, Yokoyama Y, Suzukawa K, Hasegawa Y, Chiba S. Effectiveness and safety of rabbit anti-thymocyte globulin in Japanese patients with aplastic anemia.. Int J Hematol 2013 Sep;98(3):319-22.
                            doi: 10.1007/s12185-013-1418-5pubmed: 23963878google scholar: lookup
                          30. Scheinberg P. Prognostic value of telomere attrition in patients with aplastic anemia.. Int J Hematol 2013 May;97(5):553-7.
                            doi: 10.1007/s12185-013-1332-xpubmed: 23636667google scholar: lookup
                          31. Shin SH, Lee JW. The optimal immunosuppressive therapy for aplastic anemia.. Int J Hematol 2013 May;97(5):564-72.
                            doi: 10.1007/s12185-013-1331-ypubmed: 23605367google scholar: lookup
                          32. Li X, Shi J, Ge M, Shao Y, Huang J, Huang Z, Zhang J, Nie N, Zheng Y. Outcomes of optimized over standard protocol of rabbit antithymocyte globulin for severe aplastic anemia: a single-center experience.. PLoS One 2013;8(3):e56648.
                            doi: 10.1371/journal.pone.0056648pubmed: 23554855google scholar: lookup
                          33. Sugimoto-Sekiguchi H, Tashiro H, Shirasaki R, Arai T, Yamamoto T, Oka Y, Akiyama N, Kawasugi K, Shirafuji N. Colonic EBV-Associated Lymphoproliferative Disorder in a Patient Treated with Rabbit Antithymocyte Globulin for Aplastic Anemia.. Case Rep Gastrointest Med 2012;2012:395801.
                            doi: 10.1155/2012/395801pubmed: 23050175google scholar: lookup
                          34. Scheinberg P, Young NS. How I treat acquired aplastic anemia.. Blood 2012 Aug 9;120(6):1185-96.
                            doi: 10.1182/blood-2011-12-274019pubmed: 22517900google scholar: lookup
                          35. Chen C, Xue HM, Xu HG, Li Y, Huang K, Zhou DH, Guo HX, Fang JP, Huang SL. Rabbit-antithymocyte globulin combined with cyclosporin A as a first-line therapy: improved, effective, and safe for children with acquired severe aplastic anemia.. J Cancer Res Clin Oncol 2012 Jul;138(7):1105-11.
                            doi: 10.1007/s00432-012-1184-4pubmed: 22402596google scholar: lookup
                          36. Kadia TM, Borthakur G, Garcia-Manero G, Faderl S, Jabbour E, Estrov Z, York S, Huang X, Pierce S, Brandt M, Koller C, Kantarjian HM, Ravandi F. Final results of the phase II study of rabbit anti-thymocyte globulin, ciclosporin, methylprednisone, and granulocyte colony-stimulating factor in patients with aplastic anaemia and myelodysplastic syndrome.. Br J Haematol 2012 May;157(3):312-20.
                            doi: 10.1111/j.1365-2141.2012.09064.xpubmed: 22360602google scholar: lookup
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