Use of anti-lymphocytic globulin in aplastic anaemia: a preliminary report

Abstract

Aplastic anaemia is a bone marrow stem cell disorder possibly of immunological origin. Several immune modifying agents have been subjected to clinical trials with varying degrees of success. Anti lymphocytic globulin (ALG) is either horse or rabbit globulin (anti-bodies) against lymphocytes. The present study is the first of its use in SriLanka. Seven patients (6males) with amean age of 28, 2 years, were included in this study. Severe aplastic anaemia had been diagnosed in these patients. For a period more than 6 months. Transfusion requirement was assessed during this period. Bone marrow aspiration and biopsy had been done to exclude myelofibrosis or malignant infiltration.A5 day course of ALG (Merieux) was used in all patients. The infusion of ALG was proceeded by 10mg/kg of oral prednisolone on all 5 days and prednisolone was tailed off over a month. Androgens were given from day 26. None of these patients developed anaphylaxis. Blood counts were performed daily in the first week and weekly thereafter for a period of 6 months. Patients were in complete remission if they had self sustaining normal counts, partial remission if there was an improvement of counts and decrease of transfusion requirements. Treatment failures were those in whom there was no improvement in the above indices. Final assessment was done at 3 months. Two patients had complete remission. 3 had partial remission and 2 failed to respond to ALG therapy