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Immunosuppressive therapy with rabbit antithymocyte globulin therapy for acquired aplastic anemia: a multi-institutional retrospective study in Japanese adult patients

  • Nana Sasaki
  • Kazuho Shimura
  • Mihoko Yoshida
  • Nobuhiko Uoshima
  • Miki Kiyota
  • Mayumi Hatsuse
  • Hitoji Uchiyama
  • Yoshiaki Chinen
  • Tsutomu Kobayashi
  • Mitsushige Nakao
  • Ryoichi Takahashi
  • Sonoko Nakano-Akamatsu
  • Hiroto Kaneko
  • Yutaka Kobayashi
  • Chihiro Shimazaki
  • Masafumi Taniwaki
  • Junya Kuroda
  • The Kyoto Clinical Hematology Study Group (KOTOSG) investigators
Original Article
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Abstract

We retrospectively analyzed efficacy and safety of therapy with rabbit antithymocyte globulin (rATG) in combination with cyclosporine A (CsA) in 30 Japanese adult patients with acquired aplastic anemia (AA) in the Kyoto Clinical Hematology Study Group. The median observation period was 31 months and the median age of the patients was 54 years. The objective response rates (ORRs) to rATG plus CsA increased over time until 18 months after the start of treatment; the rate of achievement of better than partial response at 18 months was 66.7%. The 2-year overall survival (OS) rate was 79% in all patients. In eight patients aged ≥ 75 years old, the ORR was 62.5% and the 2-year OS rate of 50% was not significantly inferior to that in patients aged ≤ 74 years old. The overall mortality rate was 16.7% in our cohort, while the mortality rate in patients aged ≥ 75 years old was 37.5%, which was higher than that in patients aged ≤ 74 years old (9.1%), although the difference was not statistically significant. Collectively, rATG combined with CsA is an effective and feasible treatment for AA, while patients should be appropriately selected.

Keywords

Aplastic anemia Rabbit antithymocyte globulin Immune suppressive therapy 

Notes

Acknowledgements

We are grateful to all current and past contributors to KOTOSG (Supplementary information).

Compliance with ethical standards

Conflict of interest

J.K. received grants from Sanofi, during the conduct of the study.

Supplementary material

12185_2018_2583_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 KB)
12185_2018_2583_MOESM2_ESM.docx (18 kb)
Supplementary material 2 (DOCX 18 KB)

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Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  • Nana Sasaki
    • 1
    • 3
  • Kazuho Shimura
    • 1
  • Mihoko Yoshida
    • 1
  • Nobuhiko Uoshima
    • 2
    • 3
  • Miki Kiyota
    • 2
  • Mayumi Hatsuse
    • 4
  • Hitoji Uchiyama
    • 5
  • Yoshiaki Chinen
    • 6
  • Tsutomu Kobayashi
    • 6
  • Mitsushige Nakao
    • 7
  • Ryoichi Takahashi
    • 8
  • Sonoko Nakano-Akamatsu
    • 8
  • Hiroto Kaneko
    • 1
  • Yutaka Kobayashi
    • 3
  • Chihiro Shimazaki
    • 4
  • Masafumi Taniwaki
    • 1
    • 9
  • Junya Kuroda
    • 6
  • The Kyoto Clinical Hematology Study Group (KOTOSG) investigators
  1. 1.Department of HematologyAiseikai Yamashina HospitalKyotoJapan
  2. 2.Department of HematologyMatsushita Memorial HospitalMoriguchiJapan
  3. 3.Department of HematologyJapanese Red Cross Kyoto Daini HospitalKyotoJapan
  4. 4.Department of HematologyJCHO Kyoto Kuramaguchi Medical CenterKyotoJapan
  5. 5.Department of HematologyJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
  6. 6.Division of Hematology and Oncology, Department of MedicineKyoto Prefectural University of MedicineKyotoJapan
  7. 7.Department of HematologyOtsu Municipal HospitalOtsuJapan
  8. 8.Department of HematologyOmihachiman Community Medical CenterOmihachimanJapan
  9. 9.Center for Molecular Diagnostics and TherapeuticsKyoto Prefectural University of MedicineKyotoJapan

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