Premium
Immunosuppressive therapy (IST) in adult patients with acquired aplastic anemia (AA): A single‐center experience over the past 15 years
Author(s) -
Alashkar Ferras,
Oelmüller Maren,
HerichTerhürne Dörte,
Turki Amin T.,
Schmitz Christine,
Vance Colin,
Dührsen Ulrich,
Röth Alexander
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13235
Subject(s) - aplastic anemia , medicine , single center , center (category theory) , pediatrics , anemia , gastroenterology , surgery , bone marrow , chemistry , crystallography
Objective Immunosuppressive therapy (IST) with horse anti‐thymocyte globulin (hATG) and cyclosporine (CsA) is considered one of the first‐line therapies in patients (pts) with acquired aplastic anemia (AA). Methods In our single‐center, retrospective analysis response rates (RRs) to ATG/CsA at a minimum of 6 mo were evaluated in 67 treatment‐naïve (TN) AA pts (52.2% (35/67) females; median age 45 y (range 18‐89 y)) being treated at the West German Cancer Center at the Department of Hematology at the University Hospital of Essen between April 2000 and December 2015. Results Overall 6 mo RRs in TN pts following ATG/CsA were 67.2% (45/67) (5‐year OS: 79.5%). In TN hATG‐treated pts 6 mo RRs were 75.5% (37/49) (5‐year OS: 81%) compared to 44.4% (8/18) (5‐year OS 73.5%) following rabbit ATG (rATG). Response to ATG/CsA was dependent of age, absolute reticulocyte count (ARC), and disease severity. Six mo RRs to salvage ATG/CsA in relapsed/refractory (R/R) pts were 37.5% (6/16). Conclusion Our data independently confirm the findings of previous studies that hATG/CsA is superior to rATG/CsA in TN pts. The lack of hATG availability should not result in abstaining it from an indicated ATG therapy, even though ATGAM ® is not registered in Germany.