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Efficacy of danazol in pure red cell aplasia
Author(s) -
Lippman Scott M.,
Durie Brian G. M.,
Garewal Harinder S.,
Giordano Gerald,
Greenberg Bernard R.
Publication year - 1986
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830230409
Subject(s) - danazol , pure red cell aplasia , medicine , aplastic anemia , prednisone , plasmapheresis , paroxysmal nocturnal hemoglobinuria , aplasia , refractory (planetary science) , gastroenterology , myelofibrosis , myelodysplastic syndromes , anemia , immunology , antibody , bone marrow , endometriosis , physics , astrobiology
Twenty‐one unselected patients with refractory chronic anemias of various etiologies were treated with danazol, a synthetic attenuated androgen. All had previously failed treatment with hematinics, androgens, corticosteroids, high‐dose intravenous immunoglobulin, antithymocyte globulin, cytotoxic immunosuppressive agents, and/or plasmapheresis. Three patients with pure red cell aplasia and one with aplastic anemia responded. No responses were observed in 11 patients with myelodysplastic syndromes, two patients with myelofibrosis, and two with paroxysmal nocturnal hemoglobinuria. Remission in pure red cell aplasia was maintained with danazol alone in one patient and required combined low‐dose prednisone in two. Objective responses occurred in 2 to 3 weeks and therapy generally was well tolerated. To date, one patient with pure red cell aplasia remains in complete remission at 9 months on lowdose danazol alone. We conclude that danazol alone or combined with prednisone may induce and maintain remission in severe refractory pure red cell aplasia and possibly other chronic cytopenias characterized by immunologic marrow suppression. Further trials of danazol in treating these disorders are indicated.