Treatment of aplastic anaemia with antilymphocyte globulin (ALG)

Thirty-one patients with aplastic anaemia were treated with antilymphocyte globulin (ALG) followed by anabolic steroids. All patients were reviewed at least 1 year after receiving treatment. Twenty-one patients were considered to have a severe form of aplasia. ALG from three sources was used during the trial. Sixteen patients were alive at the time of analysis, eight who had had severe aplastic anaemia (38%) and five of these no longer require blood support. No difference in response was found according to type of ALG used. Patients with a long history of aplasia before treatment fared worse than those with a short history. These results were better than those obtained with anabolic steroids alone in historical controls. It is concluded that ALG treatment is worth giving to patients with aplastic anaemia but that the optimum way of giving this immunosuppression may be different from that used in this presentation.