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A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases.

Publication ,  Journal Article
Young, N; Griffith, P; Brittain, E; Elfenbein, G; Gardner, F; Huang, A; Harmon, D; Hewlett, J; Fay, J; Mangan, K
Published in: Blood
December 1988

One hundred fifty patients with bone marrow failure were treated in three groups with antithymocyte globulin (ATG; Upjohn, Kalamazoo, MI) in a multicenter trial. Patients were assessed at 3, 6, and 12 months after initiation of treatment by three criteria: transfusion independence, clinical improvement, and blood counts. Group I consisted of 77 patients with acute severe aplastic anemia, randomized to receive either ten or 28 days of ATG. There was no significant difference between the two arms of this protocol: 47% of all patients were clinically improved and 31% were transfusion independent at 3 months. Of the severely affected patients, 27% died before 3 months; most deaths occurred early in treatment. Factors associated with survival in severely affected patients included male sex, age less than 40 years, absolute neutrophil count greater than 200/microL, and idiopathic etiology. Neutrophil counts generally increased by 8 weeks after treatment, but patients continued to show improvement to 1 year posttreatment. In Group II, 44 patients with moderate or chronic severe aplastic anemia were randomized to receive either ten days of ATG or 3 months of high-dose nandrolone decanoate. No patient initially treated with androgens recovered, but 28% of ATG-treated cases achieved transfusion independence at 3 months. Group III consisted of patients with a variety of bone marrow failure syndromes. Patients with pancytopenia and cellular bone marrow showed response rates similar to those of patients with chronic or moderate aplastic anemia.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

December 1988

Volume

72

Issue

6

Start / End Page

1861 / 1869

Location

United States

Related Subject Headings

  • Random Allocation
  • Nandrolone Decanoate
  • Nandrolone
  • Male
  • Leukocyte Count
  • Immunology
  • Humans
  • Female
  • Combined Modality Therapy
  • Clinical Trials as Topic
 

Citation

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Young, N., Griffith, P., Brittain, E., Elfenbein, G., Gardner, F., Huang, A., … Mangan, K. (1988). A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases. Blood, 72(6), 1861–1869.
Young, N., P. Griffith, E. Brittain, G. Elfenbein, F. Gardner, A. Huang, D. Harmon, J. Hewlett, J. Fay, and K. Mangan. “A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases.Blood 72, no. 6 (December 1988): 1861–69.
Young N, Griffith P, Brittain E, Elfenbein G, Gardner F, Huang A, et al. A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases. Blood. 1988 Dec;72(6):1861–9.
Young, N., et al. “A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases.Blood, vol. 72, no. 6, Dec. 1988, pp. 1861–69.
Young N, Griffith P, Brittain E, Elfenbein G, Gardner F, Huang A, Harmon D, Hewlett J, Fay J, Mangan K. A multicenter trial of antithymocyte globulin in aplastic anemia and related diseases. Blood. 1988 Dec;72(6):1861–1869.

Published In

Blood

ISSN

0006-4971

Publication Date

December 1988

Volume

72

Issue

6

Start / End Page

1861 / 1869

Location

United States

Related Subject Headings

  • Random Allocation
  • Nandrolone Decanoate
  • Nandrolone
  • Male
  • Leukocyte Count
  • Immunology
  • Humans
  • Female
  • Combined Modality Therapy
  • Clinical Trials as Topic