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

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

来源：International Journal of Hematology, 2017, 105(5): 578-586.

DOI：10.1007/s12185-017-2179-3

• Aplastic anemia
• Bone marrow failure
• Immunosuppressive therapy
• Meta-analysis

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.

• 出版日期2017-5