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Anti-thymocyte globulin in haematology: Recent developments

Salahuddin Siddiqui1, Jessica Cox2, Roger Herzig1

  • 1Department of Medicine (Hematology & BMT), University of Kentucky, Lexington, KY, USA.

The Indian Journal of Medical Research
|November 14, 2019
PubMed

Anti-thymocyte globulin (ATG) is a polyclonal antiserum introduced into clinical medicine more than 30 years ago. It induces a broad non-specific immunosuppression. In haematology, standard indications are severe aplastic anaemia and prophylaxis and treatment of graft-versus-host disease (GVHD) (after allogeneic transplantation). For aplastic anaemia, ATG from horses has been found to be superior to ATG from rabbits. In the situation of allogeneic transplantation, ATG lessens the risk of chronic GVHD but may not improve survival. There is current controversy regarding which patients benefit most from ATG and what the ideal dosage is. It is likely that in the coming years a more specific immunosuppressive will be developed that will minimize GVHD while maintaining the graft-versus-malignancy effect.

Keywords:
Anti-thymocyte globulin - graft-versus-host disease - immunosuppressive effect - myelodysplastic syndrome - severe aplastic anaemia

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