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The combination of anti-thymocyte globulin (ATG), dexamethasone, and etoposide is a chemo-immunotherapy regimen known as Hybrid ImmunoTherapy (HIT-HLH). Developed and studied by the Children's Hospital Medical Center, Cincinnati, this regimen is designed as an induction therapy for pediatric patients with hemophagocytic lymphohistiocytosis (HLH). It represents a "hybrid" approach that integrates the T-cell depleting effects of rabbit ATG (traditionally used in European protocols) with the cytotoxic backbone of etoposide and dexamethasone (the international HLH-94/2004 standard). The regimen aims to rapidly control the life-threatening hyperinflammation characteristic of HLH by targeting multiple immune pathways, including the depletion of activated T-lymphocytes and the inhibition of cytokine production.
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