Immunosuppressive Treatment (ATG)

The aim of this treatment is to use drugs to suppress the faulty immune system which stop it from attacking the stem cells and thereby allowing it to heal, recover and resume normal blood cell production. This treatment gives patients a good chance of long-term survival and a near normal or even normal quality of life. The two drugs used are a serum made in horses (or sometimes rabbits) called antithymocyte globulin (ATG) and ciclosporin (CSA).

ATG is an effective treatment for aplastic anaemia, and around two out of three (65-70%) patients respond to it. It usually takes about three to four months before ATG starts to work and slowly improves your blood counts. Patients who do not respond after three to six months may be considered for stem cell transplant from an unrelated donor or be given a second course of ATG which has a 35% chance of working.

Sometimes patients can relapse and the aplastic anaemia returns. This happens in about one third (30-35%) of patients. In these cases, ATG treatment can be repeated with about a 60% success rate.

Treatment with ATG usually involves staying in hospital for about one to two weeks.

Ciclosporin is another drug that is used to ‘dampen’ down the immune system. It is started at the same time as ATG and continues until the blood counts have improved and stabilised. This could be for a year or more.