Antithymocyte globulin treatment of severe aplastic anaemia

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Abstract
Patients (19) with severe aplastic anemia were treated with antithymocyte globulin [ATG]. Ten patients obtained remissions (transfusion indendent, at least 45,000 platelets and 2000 PMN[polymorphonuclear cells]/mm3) within 2-3 mo. and continue in remission 5-35 mo. after ATG. Ages of responders ranged from 17 to 71. Complications of ATG included arthralgias, rash, serum sickness, angioedema and fever. Two patients died during, 2 shortly after, and one 10 mo. after therapy. One patient with a previous remission following ATG relapsed and achieved a 2nd remission with retreatment. Previous androgen therapy did not affect outcome since 2 of 4 patients with and 8 of 15 patients without previous androgen therapy achieved remission with ATG. Treatment with ATG is a promising alternative to bone marrow transplantation in the treatment of severe aplastic anemia.