Antibodies in the treatment of aplastic anemia.
Antibodies have been the cornerstone of treatment of acquired aplastic anemia for more than 25 years. Treatment with antithymocyte globulin (ATG) is considered pivotal and the addition of cyclosporine improves the overall response rate. This antibody is heterogeneous and horse ATG is apparently more effective than rabbit ATG. Several issues remain unsolved in relation to the combination of ATG and cyclosporine: cost, toxicity and late clonal disorders. In recent years, alternative immunosuppressive therapy has been proposed and new antibodies have emerged: porcine ATG, alemtuzumab, daclizumab, and rituximab. Experience with these antibodies is limited to a few studies with alemtuzumab being the most promising, but the results are interesting and provocative. More studies are needed to find the perfect antibody.
Hematology Service, Hospital Universitario, UANL, Paris 3029 Col. Cumbres, 64610, Monterrey, N.L., Mexico. dr_gomez@infosel.net.mx
David
D
Gómez-Almaguer
Jose Carlos
JC
Jaime-Pérez
Guillermo J
GJ
Ruiz-Arguelles
D000074323:Alemtuzumab; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000276:immunology; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016572:Cyclosporine / Q000627:therapeutic use; D000077561:Daclizumab; D004347:Drug Interactions; D006736:Horses; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007167:Immunotherapy / Q000639:trends; D011817:Rabbits; D000069283:Rituximab; D013552:Swine
D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000961:Antilymphocyte Serum; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D000069283:Rituximab; D016572:Cyclosporine; D000077561:Daclizumab