Comparison of two types of antithymocyte globulin in the treatment of children with aplastic anemia
10.3760/cma.j.issn.0578-1310.2016.04.014
- VernacularTitle:抗人体T淋巴细胞球蛋白和兔抗人胸腺细胞免疫球蛋白治疗儿童再生障碍性贫血的效应对比研究
- Author:
Xiaotian XIE
1
;
Wei HE
;
Wei SHI
;
Xiaoxun ZHOU
;
Xiaohong QIAO
Author Information
1. 同济大学附属同济医院儿科
- Keywords:
Anemia,aplastic;
Child;
Immunosuppression;
Antithymocyte immunoglobulin
- From:
Chinese Journal of Pediatrics
2016;54(4):294-298
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study was designed to compare the effects of the anti-human T lymphocyte globulin (Fresenius,ATG-F)and rabbit anti-human thymocyte immunoglobulin (Genzyme,R-ATG) in the treatment of childhood aplastic anemia (AA) and their effects.Method A total of 59 children with aplastic anemia were analyzed in the present study,including 34 cases of severe aplastic anemia (SAA),12 cases of very severe aplastic anemia (VSAA) and 13 cases of transfusion-dependent non-severe aplastic anemia (NSAA).While receiving immunosuppressive therapy (IST),30 and 29 patients,with long-term oral supplement with cyclosporin A (CSA),androgen and Chinese traditional medicines,were treated with ATG-F and R-ATG,respectively.When it was necessary,some supportive cares such as component transfusion and infection control were also employed.Absolute counts of peripheral blood lymphocyte (ALC) at various time points were dynamically detected after ATG therapy.Result According to the International Aplastic Anemia Treatment and Effect standards.There were no statistically significant differences in the overall response rate (67％ (20/30) vs.69％ (20/29),x2 =0.036,P =0.676) and the survival rate (87％ (26/30)vs.83％ (24/29),x2 =0.173,P =0.676) between the ATG-F and R-ATG groups.There were significant and long-term ALC decrease after ATG therapy,the rate of ALC decrease in ATG-F and R-ATG group,the ALC only recovered to 47.8％ (ATG-F group) and 47.4％ (RATG group) of the pre-treatment level respectively.Conclusion ATG-F 5 mag/(kg · d) and R-ATG 3.75mg/(kg · d) could achieve similar effects in the treatment of childhood AA,through similar significant clearance of T cells.Therefore,all of these suggest that ATG-F and R-ATG might serve as the drugs of frontline choice for IST in childhood AA patients who do not have an available human leukocyte antigen identical related donor.
