title: Not all anti-T lymphocyte globulin preparations are suitable for use in aplastic anemia: significantly inferior results with jurkat cell-reactive anti-T lymphocyte globulin in clinical practice.
abstract: BACKGROUND
  Immunosuppressive therapy (IST) with anti-T lymphocyte globulin (ATG) plus cyclosporine (CSA) is standard therapy in patients with non-severe aplastic anemia (AA) in need of treatment and severe aplastic anemia (SAA) who do not have an available HLA-matched donor. The aim of this study was to analyze patients submitted to different ATG preparations as first-line treatment.
  
  
  METHODS
  We retrospectively analyzed adult aplastic anemia (AA) patients who received ATG as first-line treatment between 1999 and 2013 to compare hematologic response and survival.
  
  
  RESULTS
  During the time period mentioned 4 different ATG preparations had been used in 38 AA patients (34 severe, 4 non-severe). Responses were better with Lymphoglobulin (6 complete response 1 partial response, 0 refractory disease and 2 death within 3 months after ATG, i.e. during induction), Thymoglobulin (3, 1, 4 and 1, respectively) or ATGAM (1, 2, 1 and 1) compared to the ATG-Fresenius (ATG-F) group (3, 0, 6 and 6) (P = .07). Statistically significant inferior results with ATG-Fresenius (3 complete or partial responses, 6 refractoriness and 6 induction deaths) were evident when other preparations are lumped together (14 complete or partial responses, 5 refractoriness and 4 induction mortalities) (P = .045). Estimated 1 year survival rates were 52.5% versus 76.9%, respectively (P = .13).
  
  
  CONCLUSIONS
  These data support the notion that not all ATG preparations are suitable for use in AA.
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Eliacik
authors.initials: E
authors.lastname: Eylem
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Buyukasik
authors.initials: B
authors.lastname: Yahya
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Bektas
authors.initials: B
authors.lastname: Ozlen
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Malkan
authors.initials: M
authors.lastname: Umit
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Gunes
authors.initials: G
authors.lastname: Gursel
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Isik
authors.initials: I
authors.lastname: Ayse
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Demiroglu
authors.initials: D
authors.lastname: Haluk
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Aksu
authors.initials: A
authors.lastname: Salih
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Goker
authors.initials: G
authors.lastname: Hakan
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Sayinalp
authors.initials: S
authors.lastname: Nilgun
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Haznedaroğlu
authors.initials: H
authors.lastname: Ibrahim
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Division of Hematology Ankara, Turkey.
authors.forename: Ozcebe
authors.initials: O
authors.lastname: Osman
keywords: Aplastic anemia; anti-T lymphocyte globulin; immunosuppressive treatment