Fludarabine, cyclophosphamide plus thymoglobulin conditioning allows for the promising results of good engraftment, tolerable toxicity and minimal GVHD. Antithymocyte globulin (ATG) has been used in severe aplastic anemia (SAA) as a part of the conditioning regimen.
Is cyclophosphamide more effective than fludarabine in the salvage setting?
Conclusion: Fludarabine and cyclophosphamide seem to have a significant advantage over single-agent fludarabine in the salvage setting. Although the CR rate was not increased in previously untreated patients, residual disease detected by flow cytometry was rare and remission durations seemed to be prolonged in this subset.
How effective are cyclophosphamide and fludarabine in the treatment of alopecia areata?
Results: Fludarabine and cyclophosphamide produced > or = 80% response rates in all patients not refractory to fludarabine at the start of therapy as well as a 38% response rate in patients who were refractory to fludarabine.
Is fludarabine necessary before CAR-T cell infusion?
Prior to CAR-T cell infusion, patients underwent lymphodepletion with a high-dose cyclophosphamide (Cy)-based regimen with or without fludarabine (Flu).
How long does it take for cyclophosphamide to enter the bloodstream?
You have cyclophosphamide as tablets or as a drip into your bloodstream over 30 minutes. You have rituximab as a drip into your bloodstream. You have fludarabine as tablets or as a drip into your bloodstream over 30 minutes. You have cyclophosphamide as tablets or as a drip into your bloodstream over 30 minutes.
How effective is ATG?
Immunosuppression with anti-thymocyte globulin (ATG) was introduced in 1977. Subsequent trials confirmed the effectiveness of this form of treatment. Overall, between 75% and 80% of the patients achieve remission, defined as freedom from transfusion, following a first course of treatment with ATG.
Is ATG an immunosuppressant?
ATG is a potent immunosuppressive agent and may result in reactivation of hepatitis B in susceptible patients.
How does post transplant cyclophosphamide work?
They found that cyclophosphamide kills all of the donor's transplanted bone marrow cells except for stem cells containing high levels of an enzyme called aldehyde dehydrogenase (ALDH). The ALDH-laden stem cells evade the toxic effects of cyclophosphamide and rebuild the patient's immune system.
How do you treat ATG?
Having ATG is rather easy, it is injected into a 1000ml bag of normal saline, and attached to your picc line or Hickman line and runs for around 12 hours a day, the course is normally 4 days. Before having the first full bag they give a small dose over an hour as some may be allergic to it.
How long does ATG treatment last?
After the skin test, h-ATG will be given into a vein continuously over 4 days. Cyclosporine will also be given to improve the response rate of ATG treatment. Treatment with cyclosporine will start the same day as the h-ATG, either in liquid or capsule form, and continued for 6 months.
How much does ATG treatment cost?
Table 2ArmMean Dose (mg/kg/day)Cost/Month ($US)EPAG15030,151h-ATG3,36612,108Cyclosporine5052,013Cyclosporine (low-dose)168796Nov 12, 2019
What cyclophosphamide is used for?
Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin).
How does cyclophosphamide suppress the immune system?
CYCLOPHOSPHAMIDE is a potent immunosuppressive agent, capable of inhibiting both humoral1, 2 and cell-mediated immune responses. 3, 4, 5 In animal models, this cytotoxic agent can suppress graft-vs. -host disease,6 prevent development of certain autoallergic conditions,7 and promote tolerance to several antigens.
What is the mechanism of action of cyclophosphamide?
MECHANISM OF ACTION: Cyclophosphamide is an alkylating agent of the nitrogen mustard type. 2 An activated form of cyclophosphamide, phosphoramide mustard, alkylates, or binds, to DNA. Its cytotoxic effect is mainly due to cross-linking of strands of DNA and RNA, and to inhibition of protein synthesis.
What is ATG application?
Oracle ATG Web Commerce is a cross-channel commerce platform and software application that automates and personalizes the online buying experience. It enables enterprises to provide an online customer experience with merchandising, marketing, content personalization, automated recommendations, and live-help services.
How long does aplastic anemia last?
Aplastic anemia is a life-threatening condition with very high death rates (about 70% within 1 year) if untreated. The overall five-year survival rate is about 80% for patients under age 20. In recent years, the long-term outcomes of aplastic anemia patients have been continuously improving.
How do you administer an ATG?
ATG (rabbit) is administered by IV infusion. The manufacturer states that ATG (rabbit) should be infused through an inline 0.22-μm filter into a high-flow vein. Has also been administered via a peripheral vein† in some patients, but safety not fully established and may increase risk of thrombophlebitis and DVT.