[Therapeutic effect of antithymocyte/antilymphocyte globulin on severe aplastic anemia and therapy-related complications].

Abstract

OBJECTIVE:

Immunsuppressive therapy is a major therapy for severe aplastic anemia, and antithymocyte /antilymphocyte globulin (ATG/ALG) is usually used. This study investigated the therapeutic effect of ATG/ALG on severe aplastic anemia and explored the management of therapy-related complications.

METHODS:

Clinical data of 28 children with severe aplastic anemia who received ATG/ALG treatment from December, 1994 through to September, 2005 were analyzed retrospectively.

RESULTS:

Of the 28 patients, 2 were nearly cured (7.1%), 4 were relieved (14.3%) and 12 were improved (42.9%) based on a hemoglobin/white blood cell/platelet count. These results represented an overall effective rate of 64.3%. Clinical evidence of serum sickness developed in 19 patients, manifesting as fever (n = 9), cutaneous eruptions (n = 12), arthralgias (n = 7), myalgia (n = 7) and arthrocele (n = 3). Serum sickness occurred 5-17 days after ATG/ALG administration and lasted for 1-15 days (mean 4.4 days). Three children with mild serum sickness symptoms recovered without any treatment. The symptoms of the other 16 patients disappeared after 3-5 days of methylprednisolone treatment (10 mg/kg daily). However, 3 patients had relapses at 2-4 days after termination of methylprednisolone therapy. Another course of methylprednisolone therapy was administered to the 3 patients until the symptoms disappeared. The patients with no serum sickness or with mild serum sickness had a better response to ATG/ALG therapy than those who had severe serum sickness (100% vs 60%; P < 0.05).

CONCLUSIONS:

ATG/ALG therapy for severe aplastic anemia is effective. Serum sickness is a common complication in children with severe aplastic anemia following ATG/ALG therapy, but can be improved by methylprednisolone application.

• Authors: Fang Yu, Suo-Qin Tang, Jian-Wen Wang
• Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics (Zhongguo Dang Dai Er Ke Za Zhi) Vol. 8 Issue 6 Pg. 479-81 (Dec 2006) ISSN: 1008-8830 [Print] China
• PMID: 17178040 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antilymphocyte Serum

Topics

• Anemia, Aplastic (drug therapy)
• Antilymphocyte Serum (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Male
• Serum Sickness (etiology)
• T-Lymphocytes (immunology)