期刊
EUROPEAN JOURNAL OF HAEMATOLOGY
卷 100, 期 6, 页码 613-620出版社
WILEY
DOI: 10.1111/ejh.13057
关键词
age; antithymocyte globulin; aplastic anaemia; real-world data; response rate
类别
资金
- Goteborgs Lakaresallskap
- ALF Vastra Gotaland
ObjectivesAntithymocyte globulin (ATG)-based immunosuppression remains a cornerstone in aplastic anaemia (AA) treatment. However, most ATG studies are not population-based and knowledge about real-world results concerning response and outcome could offer important information for treating physicians. MethodsWe have recently performed a nationwide retrospective cohort study on all AA patients diagnosed in Sweden in 2000-2011 and now present treatment and outcome data on patients receiving first-line ATG. In total, 158 patients showed a 47.0% response rate which was similar in all age groups (range 41.5%-51.7%) with no difference regarding ATG formulation. The response was significantly associated with severity gradeespecially at time of treatment initiation: very severe (VSAA) 22.7%; severe (SAA) 54.5% (P<.001); and non-severe 88.5% (P<.001). A logistic regression-based predictive model indicated that VSAA patients with an absolute reticulocyte count <25x10(9)/L had only a 19% probability of response. In a multivariable analysis, age and VSAA at the time of treatment were the independent factors for inferior survival. ConclusionsReal-world VSAA patients respond poorly to ATG which indicates the need for a different treatment approach. Our findings suggest that age alone should not be a discriminating factor for administering ATG treatment.
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