Treatment of aplastic anemia with an investigational antilymphocyte serum prepared in rabbits.
The authors evaluated antilymphocyte serum prepared in rabbits (ALS-R) as an alternative to antilymphocyte serum prepared in horses (ALG-H) in the therapy of aplastic anemia. Between 1980 and 1993, 57 evaluable patients received ALS-R and prednisone +/- cyclosporine +/- androgens. Standard response criteria were used and patients were evaluated at 3 months from the start of therapy. Median age was 43 years. Disease was present for up to 2 months in 24 patients, 2-5 months in 14 patients, and 6 months or more in 19 patients. Disease was severe in 30 patients and moderate in 27. Responses occurred in 16 (28%) of 57 patients. Responses were more frequent in females, in patients treated within 6 months of diagnosis, and in patients with severe disease. Among patients receiving ALS-R and cyclosporine within 2 months of diagnosis, 46% responded. After ALS-R therapy, 20 patients received ALG-H; 8 (40%) of 20 responded. Eight patients receiving ALS-R previously had received ALG-H; 2 (25%) of these 8 patients responded. Toxicity of ALS-R was minimal. Antilymphocyte serum prepared in rabbits, in conjunction with other immunosuppressive agents, represents an effective alternative to ALG-H in aplastic anemia, especially in patients previously treated with ALG-H.
Stein
R S
RS
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, TN 37232.
Means
R T
RT
Krantz
S B
SB
Flexner
J M
JM
Greer
J P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000302:isolation & purification / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D015996:Survival Rate; D013997:Time Factors
D000961:Antilymphocyte Serum; D016572:Cyclosporine