A case report of refractory cytopenia of childhood effectively treated with low-dose rabbit anti-thymocyte globulin in immunosuppressive therapy

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  • 低用量のウサギ抗胸腺グロブリンを用いた免疫抑制療法が有効であった小児不応性血球減少症の1例

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<p>Introduction: Although the anti-thymocyte globulin (ATG) formulation has been changed from horse to rabbit ATG [thymoglobulin (TG)], an optimal TG dose has not been established. We report here a case of refractory cytopenia of childhood (RCC) successfully treated with low-dose TG (LDTG). Case: A 2-year-old girl presented with high fever and petechia three weeks before hospitalization and showed pancytopenia (WBC count, 2,100/μL; Hb level, 4.6 g/dL; Plt count, 3,000/μL). After we diagnosed her as having RCC on the basis of bone marrow examination results, she received immunosuppressive therapy (IST) using LDTG (2.5 mg/kg/day for five consecutive days). She recovered from transfusion dependence after a month and showed complete remission six months after the initiation of IST. Conclusion: IST using LDTG was effective for the treatment of pancytopenia; however, the long-term risk of relapse, clonal evolution and infection is still unclear. Further accumulation of cases is required to establish the optimal dose of TG.</p>

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