HLA DR2 - A PREDICTIVE MARKER IN RESPONSE TO CYCLOSPORINE THERAPY IN APLASTIC-ANEMIA

The effect of immunosuppressive agents on HLA DR2-aplastic anemia (AA) has recently been investigated by different groups. In the present re port, we analyzed 40 Turkish AA patients, who received immunosuppressi ve therapy (IST) and 12 AA's who were transplanted from HLA matched si blings. HLA DR2 frequency was 0.442 and significantly higher in AA's w hen compared to an unrelated healthy control group (RR: 2.93, 95% conf idence interval 1.48-5.77, P = 0.001. Patients received antithymocyte or antilymphocytic globulin (AT/LG) or AT/LG plus cyclosporine-A. (CsA ) or CsA alone. In DR2(+) and DR2(-) patients overall response rates w ere 73.3 and 30%, respectively (P = 0.03). When patients were analyzed separately, CsA administration either alone or in combination with AT /LG gave favorable results in the DR2(+) group (P = 0.02). In contrast AT/LG presence alone was shown to be inadequate. (C) 1997 Elsevier Sc ience Ireland Ltd.