Quote:
Originally Posted by curlygirl
This link is from an article from the UK, but here is a history of the rabbit vs. horse preparations. It says ATGAM is administered for 8-14 days, but I thought NIH recommends 4 or 5 days only (my son had 4):
http://www.medicinesresources.nhs.uk...Dec%202012.pdf
"The standard ATG preparation used for the treatment of AA in the UK had been horse ATG (Lymphoglobuline®, Genzyme), however this was withdrawn from the market in 2007 and replaced by rabbit ATG (Thymoglobuline®, Genzyme). Rabbit ATG had previously been used mostly for a second course of immunosuppressive therapy (IST) in patients who had relapsed or were refractory to a first course of horse ATG (2, 3). Thymoglobuline® is licensed in the UK for immunosuppression in solid organ transplantation; it is not licensed for the treatment of AA (4).
Atgam® (another horse ATG preparation) is approved in the US for the management of allograft rejection in renal transplant patients and for the treatment of moderate to severe AA in patients who are unsuitable for bone marrow transplantation (5). For AA the recommended dose regimen is 10-20 mg/kg daily for 8 to 14 days; additional alternate-day therapy up to a total of 21 doses can be administered. Because thrombocytopenia can be
associated with its administration, patients may need prophylactic platelet transfusions to maintain platelets at clinically acceptable levels.
Atgam® is not licensed in the UK but is available on a named patient basis (6)." |
Thanks so much for all you advice Curlygirl. Really is very welcome as we are feeling sometimes very isolated. I really do appreciate you taking the time to reply.
Yes I am yet to find any report where Cyclosporine is used before ATG...but my feeling was that it may be an advantage to be accustomed to that before the introduction of the ATG treatment....who knows.
Very interesting about Horse-ATG being not available across Europe etc. Great to have extra information ready for when I meet with the city doc next. Aim to print a few things out and ask for a please explain. Its not always easy asking doctors questions as they can sometimes be very superior in attitude.
Thanks also for the advice on managing transfusions and timings etc. I guess its good to know that it wasn't necessarily our naivety that got us into the emergency room for the transfusion.
Thanks again for the sense of connection.