A Phase I Study to Investigate the Safety, Tolerability, and Pharmacokinetics/Pharmacodynamics of Tripegfilgrastim (Dulastin®) after Single Administration in Pediatric Patients

Introduction: Chemotherapy-induced neutropenia (CIN) is one of main complications following systemic chemotherapy, which can cause many kinds of opportunistic infections. To overcome CIN, granulocyte colony stimulating factor (G-CSF) is usually administered to reduce neutropenic period. Tripegfilgrastim (Dulastin®) is one of pegfilgrastim drugs, which was approved for adult CIN by Korea Ministry of Food and Drug Safety in 2014. Methods: We have conducted a phase I, open-label, single ascending dose study to investigate the pharmacokinetics, safety, tolerability and pharmacodynamics of Tripegfilgrastim in pediatric patients with lymphoma or solid tumors. The patients were divided by dose of Tripegfilgrastim (60 μg/kg [lower dose, LD] and 100 μg/kg [higher dose, HD]) and age (6≤ and <12 years versus 12≤ and <19 years). Total planned number of patients was 32; 8 patients in each groups. Tripegfilgrastim was injected subcutaneously at 24 hours after the end of chemotherapy, and serial pharmacokinetic/pharmacodynamics blood samplings and safety monitoring were conducted. The trial was registered at ClinicalTrials.gov, NCT02963389. This study was supported by Dong-A ST Co., Ltd., Seoul, Republic of Korea. Results: Twenty-seven patients enrolled on this study, including 4 in LD and younger age group, 7 in LD and older age group, 8 in HD and younger age group, and 8 in HD and older age group. Six malignant germ cell tumors, 5 non-rhabdomyosarcoma soft tissue sarcomas, 4 osteosarcomas, 3 rhabdomyosarcomas, 3 neuroblastomas, 2 medulloblastomas, and 4 others were included. All enrolled patients had previously received the same-regimen chemotherapy, which had induced grade 4 neutropenia. Due to insufficient pharmacodynamics by interim analysis in some patients of LD groups, these were early closed and subsequent enrolled patients received HD of Tripegfilgrastim. The maximum concentration (Cmax) and area under the curve until 312 hours (AUC0-312h) were 89.57 ± 40.97 μg/L and 8371.99 ± 4773.29 μg∙h/L in LD group, and 130.15 ± 72.04 μg/L, 11977.40 ± 7572.29 μg∙h/L in HD group, respectively. The peak concentration was achieved at 24 hours after injection, and the Cmax and AUC0-312h of HD group were increased by 45% compared with LD group. The half-life, clearance, and volume of distribution were 47.22 hours, 0.45 L/h, 28.1 L in LD group, 40.78 hours, 0.52 L/h, 28.78 L in HD group, respectively. When these pharmacokinetics parameters were compared with our previous results of healthy adult volunteers, Cmax of LD group was similar to adult 3.6 mg injection, while Cmax and AUC0-312h of HD group were 36% and 50% of those of adult 6.0 mg injection. To investigate the pharmacodynamics, days when the absolute neutrophil count (ANC) is above 1,000/μL (T above ANC 1000), and days when ANC is below 500/μL (T below ANC 500) were evaluated. The mean T above ANC 1000 (range, days) were 7.1 days (1.6-13.6) in LD group, and 9.3 days (3.4-13.7) in HD group, respectively. Furthermore, the mean T below ANC 500 (range, days) were 4.4 days (0-10.8) in LD group, and 2.5 days (0-10.1) in HD group, respectively, which showed better pharmacodynamics in HD group. However, high inter-patient variability was observed. There was no significant difference between younger and older age groups in each LD and HD groups. There were 2 adverse drug reactions (7.4%) related to Tripegfilgrastim, which were grade 1 back pain and grade 2 arthralgia. Three severe adverse events occurred (2 bacteremia and 1 skin lesion), which resolved with further treatments. Conclusions: Tripegfilgrastim have shown safety and tolerability in pediatric patients between 6 to 19 years old with solid tumors. The pharmacokinetics parameters, Cmax and AUC0-312h of HD group were increased by 45% compared with LD group, which translates into the better pharmacodynamics parameters of HD group without increasing toxicity. Our results suggests that Tripegfilgrastim 100 μg/kg once injection could be feasible to reduce CIN in pediatric patients. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Tripegfilgrastim to investigate the safety, tolerability, and pharmacokinetics/pharmacodynamics

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Paratesticular Adipocytic Neoplasms Evaluated at a Single Institution

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.090 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S73-S74

Author(s):

Mohamed Mustafa ◽

David Priemer ◽

Muhammad Idrees ◽

Shaoxiong Chen

Keyword(s):

Spermatic Cord ◽

Older Age ◽

Age Group ◽

Single Institution ◽

Complex Anatomy ◽

Younger Age ◽

Mean Size ◽

Cord Lipoma ◽

The Mean ◽

Well Differentiated

Abstract Objectives Some of the scrotal masses are extratesticular neoplasias and develop from paratesticular tissues. Paratesticular region has a complex anatomy and contains epididymal and testicular appendages as spermatic cord, testicular tunicas, epididymis, and vestigial remnants. Therefore, neoplasms originating from this region comprise a heterogeneous group of tumors. Herein, we document paratesticular adipocytic neoplasms and the patient’s mean age and the mean size of tumor at presentation. Methods We retrospectively searched our database for paratesticular adipocytic neoplasms from the year 2001 to 2015. A total of 47 cases were identified and reports were reviewed. Results Of the total 47 cases, 28 (60%) spermatic cord lipomas, 9 (19%) well-differentiated liposarcomas, and 10 (21%) dedifferentiated liposarcomas were identified. The mean age for presentation for these diseases was of 41, 59, and 68 years, respectively. Conclusion The most common paratesticular adipocytic neoplasm in our institution is spermatic cord lipoma (60%), occurring in younger age group (mean age 40 years). However, up to 40% cases are malignant and include well-differentiated and dedifferentiated liposarcoma, occurring at a relatively older age population (59 and 68, respectively).

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A 15 Hour Dosing-Collection Interval for Plerixafor Is at Least as Effective as the Standard 10 Hour Interval.

Blood ◽

10.1182/blood.v114.22.2152.2152 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2152-2152 ◽

Cited By ~ 1

Author(s):

Eric R Rosenbaum ◽

Mayumi Nakagawa ◽

Gina Pesek ◽

John Theus ◽

Bart Barlogie ◽

...

Keyword(s):

Phase I ◽

Conflicts Of Interest ◽

P Value ◽

Number Of Patients ◽

Cd34 Cells ◽

Significant Difference ◽

The Difference ◽

Student’S T ◽

Age Range ◽

Total Average

Abstract Abstract 2152 Poster Board II-129 Introduction: Plerixafor (formerly AMD3100) is a reversible CXCR4 inhibitor used to mobilize CD34+ cells for collection and use in hematopoietic transplant. Since beginning phase I trials, the drug has been given at 10 pm and collection initiated 10h later at 8 am. After recent FDA approval, we examined use of a dosing-collection interval of 15h (5 pm administration/8 am collection) for patient (pt) convenience. Here we compare results retrospectively from phase I and II trials at our institution using the 10h interval with post-approval collections using the 15h interval. We also evaluated prechemotherapy platelet (plt) count as a predictor of response to plerixafor+G-CSF. Materials and Methods: We reviewed data for all pts (n=107) at our institution who received plerixafor using the 10h (n=79) and 15h (n=34) intervals. This group was reduced to only those who received 4 consecutive days of plerixafor (n=76), of which 67 had the 10h interval and 21 had the 15h interval. The age range of the 10h group was 30-79y (median 62) and the range of the 15h group was 45-78y (median 57). The primary disease in both groups was multiple myeloma, but included 2 NHL in the 10h group, and 5 NHL in the 15h group. Chemotherapy given prior to mobilization for both the 10h and 15h interval groups were similar and plerixafor was administered with G-CSF in all pts. CD34+ cells collected on days 1-4 were quantified by flow cytometry. Finally, some patients (n=9) underwent mobilization with plerixafor two or more times, of which 4 did so on both the 10h and 15h intervals. These instances were recorded as separate events. Prechemotherapy plt counts were also reviewed for each patient and subcategorized into 3 groups: <100, 100-150, and >150,000/uL. Mean CD34+ cells collected were compared between the plt subcategories for both the 10h and 15h groups. Results: The mean number of CD34+ cells collected for the 10h group on days 1-4 of plerixafor administration was 1.26, 1.04, 0.71, and 0.55 ×10e6 CD34+ cells/kg, respectively, with total average collection of 3.56 × 10e6 CD34+ cells/kg. For the 15h group, the average number of CD34+ cells collected on days 1-4 were 2.20, 1.61, 1.44, and 1.01 × 10e6 CD34+ cells/kg, respectively, with total average collection of 6.26 × 10e6 CD34+ cells/kg. The two groups were compared using two-tailed student's t-tests. There was no statistically significant difference between the quantity of CD34+ cells collected on days 1 or 2 for the 10h and 15h groups, however there was a statistically significant difference on days 3 and 4. On these latter two days, the 15h group collected a significantly higher number of CD34+ cells compared to the 10h group. The difference in average total collection for the two groups over all 4 days was statistically significant at an alpha level of 0.05 (p-value: 0.03). The different prechemotherapy plt groups were compared using one-way ANOVA statistical analysis. Within the 10h group the <100 group had the least amount collected (mean 2.46×10e6 CD34+/kg), the 100-150 had an intermediate amount (mean 3.30×10e6CD34+/kg), and the >150 group the most (4.30×10e6CD34+/kg; p-value 0.02). The same comparison within the 15h group showed similar findings but the number of patients in each subcategory was too small to be statistically significant. Conclusion: Administration of plerixafor with the 15h interval (5 pm dosing/8 am collection) appears to be equivalent to the standard 10h interval with regard to quantity of CD34+ cells collected over the first 2 days, and is superior to the 10 h schedule if the collection continues for 4 days. Further, prechemotherapy plt count is predictive of ability to mobilize CD34+ cells with perixafor+G-CSF for the 10h interval, as has been previously shown by our group for G-CSF alone in a similar population. Additional pts are needed to demonstrate conclusively the same finding for the 15h dosing/collection interval. Disclosures: No relevant conflicts of interest to declare.

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Concentrations of ionic, total, and bound fluoride in plasma.

Clinical Chemistry ◽

10.1093/clinchem/25.4.523 ◽

1979 ◽

Vol 25 (4) ◽

pp. 523-525 ◽

Cited By ~ 28

Author(s):

L Singer ◽

R H Ophaug

Keyword(s):

Age Groups ◽

Fluoride Concentration ◽

Older Age ◽

Male And Female ◽

Ionic Fluoride ◽

Younger Age ◽

Significant Difference ◽

The Mean ◽

Female Subjects

Abstract We found no significant difference between the means for ionic, bound, and total fluoride concentrations in the plasma of male and female subjects of the same age, living in a community with fluoridated water. When results for the 264 fasting subjects were therefore combined according to age, they indicated that persons over 60 years of age have a significantly higher mean ionic (3.89 mumol/L) and total (6.58 mumol/L) fluoride concentration in plasma than do younger age groups. For younger age groups, means ranged from 2.74 to 3.05 mumol/L for ionic fluoride and from 4.74 to 5.58 mumol/L for total. The bound fluoride concentration was lower in individuals 21 to 30 years of age (1.89 mumol/L) than in older age groups (for whom means ranged from 2.42 to 2.68 mumol/L), but was not significantly different from that of individuals who were younger (2.21 mumol/L). A tendency for the mean ionic fluoride concentration to increase with age was noted, but the concentration was significantly higher than the preceding decade group only in those persons over 60 years of age.

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Stepwise School Opening Online and Off-line and an Impact on the Epidemiology of COVID-19 in the Pediatric Population

10.1101/2020.08.03.20165589 ◽

2020 ◽

Cited By ~ 4

Author(s):

Yoonsun Yoon ◽

Kyung-Ran Kim ◽

Hwanhee Park ◽

So young Kim ◽

Yae-Jean Kim

Keyword(s):

Pediatric Patients ◽

Pediatric Population ◽

Family Members ◽

Press Release ◽

School Closure ◽

Older Age ◽

Age Group ◽

School Students ◽

Younger Age ◽

The Press

Background Data on SARS-CoV-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiologic data on pediatric COVID-19 cases after school opening is warranted. Methods We analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and re-opening policies were achieved from the press release from Korean Ministry of Education. Findings The school openings were delayed three times in March 2020. Online classes started from April 9, and off-line classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases remained around 7.0% to 7.1%. As of July 11, 45 children from 40 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 11,000 students and staff were tested; only one additional student was found to be infected in the same classroom. Among those 45, 32 (71.1%) patients had available information for the source of infection. Twenty-five (25/45, 55.6%) were infected by the family members. The proportions of pediatric patients without information on infection sources were higher in older age group (middle and high school students) than in younger age group (kindergarten and elementary school students) (47.6% vs 12.5%, p=0.010). In the younger age group, 79.1% of children were infected by family members, while only 28.6% of adolescents in the older age group were infected by family members (p<0.001). Interpretation Korea had a successful transition from school closure to re-opening with online and off-line classes. Although partial, off-line school opening did not cause significant school-related outbreak among pediatric population although young children and adolescents may have different epidemiologic features.

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Age-Related Differences in the Informational Experiences and Needs of Patients with Lymphoma: Results from the 2020 Lymphoma Coalition Global Patient Survey

Blood ◽

10.1182/blood-2021-148525 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 1929-1929

Author(s):

Olufunmilayo A Bamigbola ◽

Lorna E Warwick

Keyword(s):

Information Needs ◽

Medical Information ◽

Age Groups ◽

Older Age ◽

Age Group ◽

Younger Patients ◽

Amount Of Information ◽

Age Related ◽

Younger Age ◽

Significant Difference

Abstract Background Lymphomas can occur in all age groups but most commonly occur in older adults. Despite the shift towards patient- centered care, very little has been done to explore the information needs of patients with lymphoma by age. It is important for information to accessible to patients of all ages, as informed patients are consistently associated with better outcomes and healthcare experiences. In this study, Lymphoma Coalition (LC) describes the age-related differences in the information needs of patients with lymphoma using the 2020 LC Global Patient Survey (GPS). The objectives of this study were to identify: 1) how patients felt about the amount of information they received at diagnosis 2) the content of the information received at diagnosis and the level of understanding, and 3) their informational needs. Methods Globally, 11,878 respondents including 9,179 patients and 2,699 caregivers took part in the 2020 LC GPS. There were 9,078 patients included in this analysis who self-identified their age. These patients were grouped into five age groups for analysis: 18-29 (n=638), 30-39 (n=1,196), 40-59 (n=3,261), 60-69 (n=2,216), and 70+ (n=1,767). Demographics of the five age groups were examined, and descriptive analyses for all questions relating to information needs were performed in IBM SPSS v27. Results The five age groups differed significantly (p< 0.001) in all the demographic categories examined. These categories included lymphoma subtype, sex, area of residence, education level, employment status, and household status. Patients were asked how they felt about the amount of information given to them at diagnosis. The oldest age group (70+) reported the highest prevalence (70%) of having received the right amount of information (Table 1). The younger age groups (18-29; 30-39; and 40-59) reported the highest prevalence of not receiving enough information (38%, 42%, and 41% respectively). Although not many patients reported being given too much information, of those who did, the younger age groups (18-29; 30-39; and 40-59) were the most prevalent (10%; 7%; and 5% respectively) (Table 1). Patients were asked about the type of information given to them at diagnosis, and how well they understood it. Compared to the younger age groups, the older age groups (60-69 and 70+) more frequently reported that they received and understood information given to them on different medical treatment options, the process and stages of their care, and how to manage side effects of treatment (Table 1). Patients were also asked what they needed more information about (Table 1). The top three areas that all patients needed more information about (regardless of age group) were treatment options, side effects from treatment, and their diagnosis and what it means. There was significant difference in the prevalence of how these information needs were reported between the age groups (Table 1). There was also significant difference in the prevalence of reporting a need for more information on support for self care, psychological support/counselling, and fertility across the age categories (Table 1). The lowest prevalence for needing more information in any of these areas was observed in the older age groups (60-69 and 70+), while the highest prevalence was observed in the youngest age groups (18-29 and 30-39) (Table 1). Although few patients reported not needing more information in any of these areas, its reporting was most prevalent in the older age groups (60-69 and 70+) (12% and 19%, respectively) (Table 1). Summary/Conclusions This analysis revealed that patients with lymphoma/CLL experience medical information differently across age groups. Compared to the mid and oldest patient groups, younger patients with lymphoma or CLL reported experiencing medical information differently than older patients do and reported less understanding of the medical information given to them. The younger patients also reported higher informational needs about their disease and treatment that may also be related to their age (e.g. information on fertility and family support). Clinicians should note these differences in age-group experiences and information needs, with the understanding that younger patients with lymphoma or CLL may require additional information, attention, and support. In the future, LC would like to explore how demographic differences may have confounded results. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Clinical characteristics of chronic lymphocytic leukemia in young versus old age patients in Kurdistan region- Iraq

10.53350/pjmhs211571930 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1930-1935

Author(s):

Lara Lateef Abdulrahman ◽

Ranan Kardagh Polus ◽

Ghanim Salim Numan

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Old Age ◽

International Workshop ◽

Lymphocytic Leukemia ◽

Older Age ◽

Survival Duration ◽

Age Group ◽

Kurdistan Region ◽

Younger Age ◽

The Mean

Background: Chronic lymphocytic leukemia is the common adulthood leukemic type, although the incidence rate in the Kurdistan region is low. It is well known that chronic lymphocytic leukemia is prevalent among the elderly age group, however frequent cases of chronic lymphocytic leukemia are newly diagnosed at a younger age. Aim of the study: To analyze the difference in disease presentation, progression, and outcome between young and old age group patients with chronic lymphocytic leukemia in the Kurdistan region/Iraq. Patients & Methods: A retrospective cross-sectional review study carried out in three oncology centers in the Kurdistan region (Nanakaly Hospital in Erbil city, Hiwa center in Sulaimani city, and Azadi center in Duhok city) for ten years through the period from 1st of January, 2010 to 31st of December, 2019 on a convenient sample of 152 patients with chronic lymphocytic leukemia. Diagnosis of chronic lymphocytic leukemia was done by the Oncologists in Kurdistan tumor centers according to the International Workshop on Chronic Lymphocytic Leukemia. The age of patients at diagnosis was categorized into two groups and ranged from 25 years to 94 years. The age cutoff value in the current study was (55 years) depending on previous kinds of literature. Results: The mean age at diagnosis of patients was (63 years); 28% of them were diagnosed at age of ≤50 years and 72% of them were diagnosed at age of more than 55 years. Older age patients were significantly presented with weight loss, while younger age patients were significantly presented with neck lumps. There was a highly significant association between the advanced ECOG performance scale and older age patients at diagnosis. A significant association was observed between the death outcome of chronic lymphocytic leukemia and older age patients at diagnosis. The mean survival duration of younger age patients at diagnosis was significantly longer than the mean survival duration of older age patients at diagnosis. Conclusions: clinical presentation, physical status, death rates, and survival of patients with chronic lymphocytic leukemia in Kurdistan region-Iraq are different between young and older age patients. Keywords: Chronic Lymphocytic Leukemia, age, death, Survival.

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Pilot study of ziv-aflibercept in myopic choroidal neovascularisation patients

BMC Ophthalmology ◽

10.1186/s12886-020-01679-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Amin E. Nawar ◽

Heba M. Shafik

Keyword(s):

Intravitreal Injection ◽

Outcome Measures ◽

Macular Thickness ◽

Older Age ◽

Central Macular Thickness ◽

Age Group ◽

Younger Age ◽

Number Of Patients ◽

Myopic Cnv

Abstract Background Myopic choroidal neovascularization (CNV) is the most common sight-threatening complication associated with high myopia. The present study evaluated the efficacy and safety of the intravitreal injection of ziv-aflibercept in patients with myopic CNV. Methods This prospective interventional study was conducted on 20 eyes of 20 patients with active myopic CNV. Twelve patients were 40 years or older. This study was performed in the Ophthalmology Department of Tanta University Eye Hospital, Tanta University, Egypt. Optical coherence tomography (OCT) was performed for all patients at baseline and monthly after injection during the 6-month follow up period. The main outcome measures were changes in BCVA and CMT. The exploratory outcome measures were CNV size, IOP and the number of injections needed in each age group during the study period. Results Patients with myopic CNV younger than 40 years needed fewer injections (2.00 ± 0.76) than patients older than 40 years (2.50 ± 1.00), with no statistical significance detected between the two groups (p-value 0.246). CNV was smaller in the younger age group (p-value 0.209), best corrected visual acuity (BCVA) improved significantly in the younger and older age groups (p-values 0.001 and 0.028, respectively), and central macular thickness (CMT) decreased significantly after 6 months, from 242.88 ± 23.83 μm to 191.13 ± 13.83 μm in the younger age group and from 251.33 ± 26.60 μm to 197.08 ± 17.64 μm in the older age group (p = 0.001). No significant correlation was found between the final BCVA and either the spherical equivalent or central macular thickness after 6 months, with p-values of 0.135 and 0.145, respectively. No significant changes in IOP were detected in either group after the intravitreal injection. Conclusion Ziv-aflibercept is a highly effective and safe drug in cases of active myopic CNV; however, a larger number of patients and a longer follow-up period are needed to confirm our results. This study was retrospectively registered at clinicaltrials.gov (ID: NCT04290195) on 26-2-2020.

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Response to Immunosuppressive Therapy with Antithymocyte Globulin (ATG) In Older Patients with Aplastic Anemia

Blood ◽

10.1182/blood.v118.21.4374.4374 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4374-4374

Author(s):

Biju George ◽

Vikram Mathews ◽

Kavitha M Lakshmi ◽

Rayaz Ahmed ◽

Aby Abraham ◽

...

Keyword(s):

Aplastic Anemia ◽

Immunosuppressive Therapy ◽

Older Patients ◽

Antithymocyte Globulin ◽

Conflicts Of Interest ◽

Age Groups ◽

Older Age ◽

Serum Sickness ◽

Age Group ◽

Number Of Patients

Abstract Abstract 4374 Immunosuppressive therapy (IST) with antithymocyte globulin in combination with prednisolone and cyclosporine is the treatment of choice for patients with aplastic anemia who are ineligible for transplant either because of age or because of absence of a HLA identical donor. Limited data that exists on the role of immunosuppressive therapy in older patients with aplastic anemia suggest that responses were poorer. This retrospective analysis was aimed at determining whether older patients with aplastic anemia had an inferior response to IST compared with younger patients. Between October 1985 to December 2010, 322 adult patients (>12 years) were treated at our centre with antithymocyte globulin (ATG) in combination with prednisolone and with/without cyclosporine. Either ATGAM (Pharmacia Upjohn, USA) at 40 mg/kg/day × 4 days or Lymphoglobulin (Pasteur Merieux, France) at 15 mg/kg/day × 5 days was used. Prednisolone at 1 mg/kg in 3 divided doses were started one day after completion of ATG and tapered from Day +14 if there was no evidence of serum sickness. Cyclosporine at the dose of 6 mg/kg/day in 2 divided doses was started once steroids were tapered and then continued for 12 months and then tapered depending upon response. Patients were divided into 3 age groups - Ages 12 – 29 [n=116], ages 30 – 49 [n = 116] and > 50 years [n = 90]. The baseline characteristics are detailed in the table below – Thirty one patients were above the age of 60 years. The older age group had significantly higher % of males, more use of ATGAM compared with Lymphogloblin and a higher number was given Cyclosporine (CSA) post ATG. The severity of aplastic anemia (severe vs non-severe) and the median time from diagnosis to administration of ATG was not significantly different between the 3 groups. The number of patients who developed serum sickness was significantly lower in the older age group (21.1%) compared to the age group of 30 – 49 (35.3%) and 12 – 29 years (48.3%) [p = 0.000]. The overall response to ATG was similar in all 3 groups (63.8% in age 12 –29, 64.7% in ages 30 – 49 and 54.4% in age > 50 yrs) [p = 0.233]. The response in patients above the age of 60 years was 51.6%. Six patients received a second course of ATG while 3 patients underwent HLA identical sibling donor transplantation. At a median follow up of 32 months (range: 1 –145), 221 patients (68.6%) are alive. The overall survival is similar for the older age group compared with the younger age groups (66.7% with age>50 years, 68.1% with age 30–49 and 70.7% with age 12 –29) [p= 0.817]. In conclusion, immunosuppressive therapy with ATG has a reasonable outcome in older patients (> 50 years) with aplastic anemia.Table 1:Demographic characteristics and outcome of IST among the 3 age groupsVariables12 – 29 yrs (n = 116)30 – 49 yrs (n = 116)>50 yrs (n = 90)p valueMale84 (72.4%)87 (75%)52 (57.8%)Female32 (27.6%)29 (25%)38 (42.2%)0.019Severity of AA86 (74.1%)77 (66.4%)63 (70%)0.581VSAA + SAA30 (25.9%)39 (33.6%)27 (30%)NSAAType of ATG45 (38.8%)33 (28.4%)53 (58.9%)0.000ATGAM71 (61.2%)83 (71.6%)37 (41.1%)LymphoglobulinCSA used92 (79.3%)103 (88.8%)85 (94.4%)0.005Yes24 (20.7%)13 (11.2%)5 (5.6%)NoResponse74 (63.8%)75 (64.6%)49 (54.4%)0.233Overall response34 (29.3%)28 (24.1%)15 (16.7%)Complete response (CR)40 (34.5%)47 (40.5%)34 (37.8%)Partial response (PR)42 (36.2%)41 (35.3%)41 (45.6%)No response (NR)Overall survival82 (70.7%)79 (68.1%)60 (66.7%)0.817Alive34 (29.3%)37 (31.9%)30 (33.3%)Dead Disclosures: No relevant conflicts of interest to declare.

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