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

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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.

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Acknowledgements

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

Author information

Author notes

  1. Nana Sasaki and Kazuho Shimura contributed equally to this study.

Authors and Affiliations

  1. Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan

    Nana Sasaki, Kazuho Shimura, Mihoko Yoshida, Hiroto Kaneko & Masafumi Taniwaki

  2. Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan

    Nobuhiko Uoshima & Miki Kiyota

  3. Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan

    Nana Sasaki, Nobuhiko Uoshima & Yutaka Kobayashi

  4. Department of Hematology, JCHO Kyoto Kuramaguchi Medical Center, Kyoto, Japan

    Mayumi Hatsuse & Chihiro Shimazaki

  5. Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan

    Hitoji Uchiyama

  6. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yoshiaki Chinen, Tsutomu Kobayashi & Junya Kuroda

  7. Department of Hematology, Otsu Municipal Hospital, Otsu, Japan

    Mitsushige Nakao

  8. Department of Hematology, Omihachiman Community Medical Center, Omihachiman, Japan

    Ryoichi Takahashi & Sonoko Nakano-Akamatsu

  9. Center for Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Masafumi Taniwaki

Authors
  1. Nana Sasaki
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The Kyoto Clinical Hematology Study Group (KOTOSG) investigators

Corresponding author

Correspondence to Junya Kuroda.

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Conflict of interest

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

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Sasaki, N., Shimura, K., Yoshida, M. et al. Immunosuppressive therapy with rabbit antithymocyte globulin therapy for acquired aplastic anemia: a multi-institutional retrospective study in Japanese adult patients. Int J Hematol 109, 278–285 (2019). https://doi.org/10.1007/s12185-018-02583-w

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  • DOI: https://doi.org/10.1007/s12185-018-02583-w

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