Treatment of aplastic anemia with antithymocyte globulin, cyclosporin A, methylprednisolone, danazol and recombinant human granulocyte-colony stimulating factor

Acta Paediatr Jpn. 1996 Dec;38(6):644-7. doi: 10.1111/j.1442-200x.1996.tb03724.x.

Abstract

The main purpose of the present study was to determine the response rate to immunosuppressive therapy combined with recombinant human granulocyte-colony stimulating factor (rhG-CSF) and its efficacy for preventing infections in patients with severe aplastic anemia. The treatments included one course of antithymocyte globulin, cyclosporin A, methylprednisolone, danazole and rhG-CSF. Three patients had very severe aplastic anemia and two had moderate aplastic anemia. One patient relapsed 13 months following the first course of therapy and received a second course. Five patients received six courses of treatment and the response rate at 6 months was 83.3%. All patients achieved an absolute neutrophil count of greater than 1.0 x 10(9)/L within 40 days. All patients with a complete response are transfusion-free and doing well. All five patients are currently alive and have not had any episode of infection for 17-53 months. The results of the study indicate that this therapy may improve the poor prognosis of young patients with severe aplastic anemia. It has a good response rate and induces a rather rapid increase in the neutrophil count, which protects against life-threatening bacterial and fungal infections.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Aplastic / therapy*
  • Antilymphocyte Serum / administration & dosage*
  • Child
  • Child, Preschool
  • Cyclosporine / administration & dosage*
  • Danazol / administration & dosage*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Male
  • Methylprednisolone / administration & dosage*
  • Recombinant Proteins

Substances

  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Cyclosporine
  • Danazol
  • Methylprednisolone