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Treatment of Acquired Aplastic Anemia with Cyclosporine and Androgens

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Aplastic Anemia and Other Bone Marrow Failure Syndromes

Abstract

Numerous laboratory and clinical investigations have suggested that immunological mechanisms may be responsible for the hemopoietic suppression in a large number of patients with aplastic anemia. Bone marrow culture studies incubating T-lymphocytes from these patients with normal allogeneic bone marrow have resulted in a decrease in the number of erythroids and myeloid colony formation in cultures.1–3 Conversely, bone marrow T cell depletion has resulted in an increase in the number of colonies.4 More recently, it has been demonstrated that the majority of patients with aplastic anemia exhibit a large number of circulating activated T-lymphocytes, producing γ interferon.5–7 Since various studies have shown an inhibitory effect of this lymphokine on hematopoiesis in vitro 8–10 and in vivo,11 it has been postulated that γ interferon may play an important role in the pathogenesis of acquired aplastic anemia.12 On clinical grounds, it has been found that prior immunosuppressive conditioning is necessary for successful bone marrow transplantation in identical twins in approximately half of the cases.13,14 In addition, some patients conditioned by immunosuppressive agents including antilymphocyte globulin (ALG) for bone marrow transplantation have achieved autologous bone marrow regeneration.15–18 The above observations have led to several therapeutic trials with antilymphocyte globulin (ALG) and antithymocyte globulin (ATG) in patients with acquired aplastic anemia with variable rates of response ranging from 17 to 85%.19,20 Most studies, including a recent multicenter trial, however, have reported a hematologic response in 40–60% of the patients.21

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Authors
  1. N. T. Shahidi
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  2. W. Wang
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  3. S. Shurin
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  4. J. Finlay
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  5. P. Sondel
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  6. P. Dinndorf
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Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, 53792, USA

    Nasrollah T. Shahidi

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© 1990 Springer-Verlag Inc.

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Shahidi, N.T., Wang, W., Shurin, S., Finlay, J., Sondel, P., Dinndorf, P. (1990). Treatment of Acquired Aplastic Anemia with Cyclosporine and Androgens. In: Shahidi, N.T. (eds) Aplastic Anemia and Other Bone Marrow Failure Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3254-4_14

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  • DOI: https://doi.org/10.1007/978-1-4612-3254-4_14

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7935-8

  • Online ISBN: 978-1-4612-3254-4

  • eBook Packages: Springer Book Archive

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