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International Journal of Hematology
Published in: International Journal of Hematology 5/2017

01-05-2017 | Original Article

Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia

Authors: Jin Hayakawa, Junya Kanda, Yu Akahoshi, Naonori Harada, Kazuaki Kameda, Tomotaka Ugai, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Masahiro Ashizawa, Miki Sato, Kiriko Terasako-Saito, Shun-ichi Kimura, Misato Kikuchi, Rie Yamazaki, Shinichi Kako, Yoshinobu Kanda

Published in: International Journal of Hematology | Issue 5/2017

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Abstract

Aplastic anemia patients who received rabbit antithymocyte globulin exhibited response and survival rates inferior to those who received horse antithymocyte globulin in several studies. Therefore, we conducted a meta-analysis to compare rabbit and horse antithymocyte globulin as immunosuppressive therapy for aplastic anemia. We searched online databases for studies that compared antithymocyte globulin regimens as first-line treatment for aplastic anemia, including both randomized and non-randomized controlled trials. The early mortality rate at 3 months and overall response rate at 6 months were evaluated. Thirteen studies were included in the analysis. The risk ratio (RR) of early mortality for rabbit vs. horse antithymocyte globulin was 1.33 [95% confidence interval (CI) 0.69–2.57; P = 0.39], with significant heterogeneity. A sensitivity analysis suggested higher early mortality rate in patients who received rabbit antithymocyte globulin. The overall response rate was significantly higher in patients who received horse antithymocyte globulin (RR 1.27; 95% CI 1.05–1.54; P = 0.015). In conclusion, in aplastic anemia patients treated with ATG, early mortality rate was not significantly different in patients receiving horse or rabbit ATG, although a sensitivity analysis showed higher early mortality in the rabbit ATG group. Horse ATG was associated with significantly higher response rate than rabbit ATG.
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Metadata
Title
Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia
Authors
Jin Hayakawa
Junya Kanda
Yu Akahoshi
Naonori Harada
Kazuaki Kameda
Tomotaka Ugai
Hidenori Wada
Yuko Ishihara
Koji Kawamura
Kana Sakamoto
Masahiro Ashizawa
Miki Sato
Kiriko Terasako-Saito
Shun-ichi Kimura
Misato Kikuchi
Rie Yamazaki
Shinichi Kako
Yoshinobu Kanda
Publication date
01-05-2017
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 5/2017
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-017-2179-3

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