title: Efficacy of porcine antihuman lymphocyte immunoglobulin compared to rabbit antithymocyte immunoglobulin as a first-line treatment against acquired severe aplastic anemia.
abstract: Immunosuppressive therapy (IST) with antithymocyte immunoglobulin (ATG) or antilymphocyte immunoglobulin (ALG) and cyclosporine A (CsA) is the treatment of choice against severe aplastic anemia (SAA) worldwide. However, a comparison of the efficacy of porcine ALG (pALG) and rabbit ATG (rATG) as a first-line treatment for acquired SAA has not been reported. In the present study, we retrospectively analyzed SAA patients treated with either pALG (n = 43) or rATG (n = 32) and compared their hematologic responses and survivals. There were no significant differences in overall response (OR) rates between pALG and rATG groups at 3 months (OR 41.86 versus 40.62% (P = 0.914), 6 months (OR 66.67 versus 61.29% (P = 0.635), 9 months (OR 69.05 versus 61.29% (P = 0.490), or 12 months (OR 69.05 versus 64.51% (P = 0.684), respectively. The OR rates in patients with SAA or very severe aplastic anemia (vSAA) in both groups were similar after a 12-month treatment (pALG 74.07 versus 60.00%, P = 0.550; rATG 70.00 versus 54.55%, P = 0.640). Patients who experienced <30-day interval between diagnosis and treatment displayed higher OR rates (at 12 months) than those with intervals ≥30 days (pALG 83.33 versus 50.00%, P = 0.021; rATG 87.50 versus 40.00%, P = 0.006). There were no significant differences in 2-year overall survival (OS) between pALG (87.4 ± 6.2%) and rATG (83.2 ± 7.8%) (P = 0.493). Infection was the major cause of death in both groups. In summary, pALG + CsA showed similar efficacy as rATG + CsA, as a first-line treatment for acquired SAA.
authors.affiliation: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province, 215006, People's Republic of China.
authors.forename: Limin
authors.initials: L
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Ding
authors.forename: Lin
authors.initials: L
authors.lastname: Hao
authors.forename: Xingxia
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.forename: Liansheng
authors.initials: L
authors.lastname: Zhang
authors.forename: Zhengdong
authors.initials: Z
authors.lastname: Hao
authors.forename: Meiqing
authors.initials: M
authors.lastname: Lei
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhang
authors.forename: Depei
authors.initials: D
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000188:drug therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012189:Retrospective Studies; D013552:Swine; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents