Relationship between plasma rabbit anti‐thymocyte globulin concentration and immunosuppressive therapy response in patients with severe aplastic anemia

Autor:	Asahito Hama, Nozomu Kawashima, Motoharu Hamada, Nobuhiro Nishio, Seiji Kojima, Eri Nishikawa, Shinji Nakao, Yusuke Okuno, Daisuke Ichikawa, Hideki Muramatsu, Kyogo Suzuki, Hirohito Yamazaki, Yoshiyuki Takahashi, Atsushi Narita
Rok vydání:	2021
Předmět:	Adult Male medicine.medical_specialty Adolescent Globulin Comorbidity Severity of Illness Index Gastroenterology Immunophenotyping Young Adult 03 medical and health sciences Immune Reconstitution 0302 clinical medicine Internal medicine medicine Humans Lymphocyte Count Rabbit ATG Aplastic anemia Child Aged Antilymphocyte Serum Immunosuppression Therapy biology business.industry Anemia Aplastic Disease Management Infant Hematology General Medicine Odds ratio Middle Aged Prognosis medicine.disease Severe Aplastic Anemia Confidence interval Anti-thymocyte globulin Treatment Outcome Therapy response ROC Curve Child Preschool 030220 oncology & carcinogenesis biology.protein Female business Biomarkers Immunosuppressive Agents 030215 immunology
Zdroj:	European Journal of Haematology. 107:255-264
ISSN:	1600-0609 0902-4441
Popis:	Objectives Patients with acquired aplastic anemia (AA) without HLA-matched sibling donors or aged >40 years receive immunosuppressive therapy (IST) with anti-thymocyte globulin (ATG). We investigated the relationship between plasma rabbit ATG (r-ATG) concentration and IST response. Methods From May 2012 to October 2017, 81 patients with severe AA who required initial IST were included. A 1:1 block randomization was employed for 2.5 and 3.5 mg/kg doses of r-ATG. Results No significant difference in response rates was observed between the 2.5 and 3.5 mg/kg groups (63% vs. 58%, P = .894). Median r-ATG concentrations on days 14 and 28 after IST were 15.2 (0.0-97.7) and 1.8 (0.0-74.9 µg/mL), respectively. According to r-ATG concentration, response rates were significantly higher in the group with higher r-ATG concentration than in those with lower r-ATG concentration (day 14, 88% vs. 52%; P = .006 and day 28, 79% vs. 46%; P = .005). In multivariate analysis, higher r-ATG concentrations at day 28 were independent predictors of favorable response to IST at 6 months (odds ratio, 0.29; 95% confidence interval, 0.09-0.93; P = .037). Conclusions The present data indicate that higher r-ATG concentration at day 28 resulted in improved IST response.
Databáze:	OpenAIRE
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