Treatment of severe aplastic anemia with cyclosporin-a and high-dose methylprednisolone

Authors : N Üskent, M Danacı, M Özel, M Yaylacı, H Tor

Pages : 27-30

View : 15 | Download : 9

Publication Date : 1992-01-01

Article Type : Research Paper

Abstract :15 patients with severe aplastic anemia were treated with an immunosuppresive regimen consisting of Cyclosporin-Ainsert ignore into journalissuearticles values(CsA); and highdose méthylprednisolone insert ignore into journalissuearticles values(HMP);. Initially CsA was given orally at a dosage of 10 mg/kg/day and monitoring the serum level of the drug, blood levels of 200-500 ng/ml were maintained thereafter. CsA treatment was continued at least 3 months at which time the treatment was terminated in unresponsive patients depending on the peripheral cell counts. HMP was administered simultaneously with CsA at 30 mg/kg/day IV for 3 days, 20 mg/kg/day IV for 3 days and 10 mg/kg/day IV for 4 days. Within 3 months improvement of hematopoiesis was seen in 6 patients insert ignore into journalissuearticles values(40 %);. First signs of response were seen in 21-69 insert ignore into journalissuearticles values(34); days. This was followed by complete remission in 3 patients, partial remission in 2 patients and minimal improvement in 1 patient. Remissions were proved to be dependent on the continued administration of CsA. Sequential changes of T-cell subsets using APAAP method revealed an increasing ratio of T-helper cells to T-suppressor cells. This Observation strongly suggests the role of T-cells in the pathogenesis of some cases of aplastic anemia.
Keywords : APAAP