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Treatment of aplastic anemia with antithymocyte globulin, cyclosporin A, methylprednisolone, danazole and recombinant human granulocyte‐colony stimulating factor
Author(s) -
SHICHINO HIROYUKI,
MUGISHIMA HIDEO,
TAKAMURA MAYUMI,
SHIMADA TOSHIAKI,
SUZUKI TAKASHI,
CHIN MOTOAKI,
HARADA KENSUKE,
RYO SIGEO,
KOJIMA SEIJI
Publication year - 1996
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1996.tb03724.x
Subject(s) - medicine , aplastic anemia , methylprednisolone , granulocyte colony stimulating factor , globulin , granulocyte , anemia , absolute neutrophil count , gastroenterology , surgery , immunology , chemotherapy , bone marrow , neutropenia
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 × 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.