Indications
Anti-human T-lymphocyte immunoglobulin is used together with other immunosuppressive medicines to suppress the immune competent cells that cause acute rejection or graft versus host disease. Grafalon is indicated in the same way. It is usually given for the following purposes. Prevention of acute transplant rejection in patients receiving allogeneic solid organ transplants: Anti-human T-lymphocyte immunoglobulin is used in combination with other immunosuppressive medicines (e.g. glucocorticosteroids, purin antagonists, calcineurin inhibitors or mTOR inhibitors) to enhance immunosuppression after allogeneic solid organ transplantation. Therapy of acute corticosteroid-resistant rejection after allogeneic solid organ transplantation: It is indicated for treating acute corticosteroid-resistant rejection episodes after allogeneic solid organ transplantation, if treatment with methyl-prednisolone has not worked well enough. Prevention of graft-versus-host disease (GVHD) in adults after allogeneic stem cell transplantation (SCT): Anti-human T-lymphocyte immunoglobulin is indicated to prevent graft-versus-host disease (GVHD) in adults with haematological malignancies after stem cell transplantation from matched unrelated donors. It is given in combination with standard Cyclosporin A/methotrexate prophylaxis.
⚠️ Always consult a registered physician before taking any medicine.
Pharmacology
Anti-human T-lymphocyte immunoglobulin is a polyclonal anti-T-lymphocyte immunoglobulin made from rabbits that have been immunized with Jurkat cells, a lymphoblastoid cell line. Jurkat cells carry T-cell markers, and this fits with the effects the immunoglobulin has on lymphocytes. It has also been found to contain antibodies against other surface antigens of Jurkat cells. When lymphocyte subsets were analysed in patients who received Anti-human T-lymphocyte immunoglobulin, those carrying surface proteins expressed by the Jurkat cell line were reduced.
The immunoglobulin is cytotoxic against human lymphocytes, and the data show that activated lymphocytes are more susceptible. It did not activate T-cells (via CD3) or lymphocytes, but it did inhibit activation of T-cells by an anti-CD3 antibody. It also reduced migration of human melanoma cells by binding to adhesion molecules.
Its anti-adhesive properties (anti-LFA-1 and anti-ICAM-1 activity) might explain a finding in porcine kidneys. These kidneys were perfused with human lymphocytes that had been incubated with or without the immunoglobulin. Where it was added, the vascular resistance of the kidney vessels was lower and fewer lymphocytes were retained in the kidney.
In rhesus monkeys, Anti-human T-lymphocyte immunoglobulin prolonged skin graft survival. Immunosuppression was clear in this model, and leukopenia and lymphopenia were observed. In cynomolgus monkeys, it had a beneficial effect on ischemia/reperfusion injury by inhibiting the adhesion of lymphocytes and neutrophils.
Pregnancy & Breastfeeding
We don't know what risk anti-human T-lymphocyte immunoglobulin may carry for the fetus, so doctors should be careful when prescribing it to pregnant women. Human immunoglobulin, at the very least, can potentially cross the placental barrier and pass into human breast milk. For this reason, the treating physician should decide whether to treat a pregnant or breastfeeding woman, based on an assessment of the risk against the benefit.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Dosage Reference
⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.