title: Horse anti-thymocyte globulin and eculizumab as concomitant therapeutic approach in an aplastic paroxysmal nocturnal hemoglobinuria patient: go or no-go?
abstract: We present the case of a 64-yr-old female paroxysmal nocturnal hemoglobinuria (PNH) patient with subsequent transition to severe aplastic anemia in whom a concomitant successful immunosuppressive therapy (horse anti-thymocyte globulin (hATG) and cyclosporin A) in addition to an ongoing long-term treatment with the terminal complement inhibitor eculizumab was initiated. No reduced ATG efficacy or severe adverse events were observed in the presence of eculizumab. In addition, the possible reoccurrence of PNH symptoms (thromboembolic events and/or intravascular hemolysis) was prevented, while T-cell depletion was similar to non-eculizumab-treated patients with partial remission being evident by day 83.
authors.affiliation: Department of Haematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Ferras
authors.initials: F
authors.lastname: Alashkar
authors.affiliation: Department of Haematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dührsen
authors.affiliation: Department of Haematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. alexander.roeth@uk-essen.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Röth
mesh_terms: D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000175:diagnosis / Q000188:drug therapy*; D006461:Hemolysis / Q000187:drug effects; D006736:Horses; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; C481642:eculizumab
keywords: aplastic anemia; eculizumab; horse anti-thymocyte globulin; paroxysmal nocturnal hemoglobinuria