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Efficacy of Rabbit Anti-Thymocyte Globulin in Severe Aplastic Anemia

Efficacy of Rabbit Anti-Thymocyte Globulin in Severe Aplastic Anemia

Manuel G Afable 2nd, Mohammed Shaik, Yuka Sugimoto, Paul Elson, Michael Clemente, Hideki Makishima, Mikkael A Sekeres, Alan Lichtin, Anjali Advani, Matt Kalaycio, Ramon V Tiu, Christine L O'Keefe, Jaroslaw P Maciejewski

Haematologica. 2011 Sep;96(9):1269-75.

PMID: 21606164

Abstract:

Background:
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.
Design and 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).

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
IAR42416582	Anti-phospho-Connexin 43 (pTyr265) antibody produced in rabbit			Price

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