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Oral cyclosporin‐A is effective treatment for untreated and also for previously immunosuppressed patients with severe bone marrow failure *
Author(s) -
HinterbergerFischer Margareta,
Höcker Paul,
Lechner Klaus,
Seewann Heinz,
Hinterberger Wolfgang
Publication year - 1989
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1989.tb00269.x
Subject(s) - medicine , immunosuppression , methylprednisolone , bone marrow , gastroenterology , bone marrow failure , aplasia , surgery , globulin , haematopoiesis , stem cell , biology , genetics
16 patients with transfusion‐dependent, life‐threatening bone marrow failure (14 with severe aplastic anaemia, 1 with systemic lupus erythematosus and 1 with pure red cell aplasia) were treated with cyclosporin‐A (Cy‐A) after either lack of response to conventional immunosuppression with antithymocyte‐globulin/high‐dose methylpred‐nisolone for 95 to 1190 days (median 186.5) (group I, 8 patients) or as a primary treatment due to ineligibility for conventional immunosuppression (group II, 8 pat.). Cyclosporin‐A was given orally to maintain trough levels of 200 to 300 ng/ml (RIA). In group I, 6 out of 8 patients responded 30 to 480 d (median 53) and are currently alive 627 to 1482 d (median 731) after initiation of Cy‐A, respectively. In 3 of the responders Cy‐A has been withdrawn, without relapse. In group II, 5 of 8 patients responded 26 to 170 d (median 63) and are currently alive 142 to 697 (median 420) d following initiation of Cy‐A, respectively. These data indicate a place for cyclosporin‐A in the management of patients with life‐threatening bone marrow failure in whom a) immunosuppressive therapy with antithymocyte‐globulin and high‐dose methylprednisolone had failed and b) who are not candidates for vigorous immunosuppression or bone marrow transplantation, for medical or other reasons.