APLASTIC-ANEMIA TREATMENT WITH CYCLOSPORI NE, PREDNISONE AND ANDROGENS (PRELIMINARY-RESULTS IN 10 PATIENTS)

Aplastic anaemia is a potentially fatal haematopoietic disorder whose aetiology is not yet clarified. In our preliminary study we have intro duced cyclosporin in the aplastic anaemia treatment to evaluate its ef fect on the disease evolution. Ten aplastic anaemia patients, mean age 33.33 +/- 20.01 years, were heated with cyclosporine (9 +/- 2.35 mg/k g/d), prednisone (0.5 mg/kg/d) and androgens (1 mg/kg/d). The predniso ne was always combined dth cyclosporine. The androgens were administer ed concomitantly with the cyclosporine or alternately. Seven patients responded to the treatment after a median remission delay of 6 weeks ( 2-12 weeks). They became independent of blood requirements at a median of 36 weeks (8-108 weeks); the three other patients died during the f irst trimester without showing any improvement. Among the seven respon ders, two relapsed early and transiently. The rate of actuarial surviv al was 70 per cent. The median duration of survival was 10.5 months. T he side effects observed included one case of malignant lymphoma, six cases of liver toxicity and five cases of kidney toxicity. This toxici ty was reversible after dose adjustment of the cyclosporine. In our st udy, the introduction of cyclosporin in the aplastic anaemia treatment resulted in improved therapeutic response. Androgens should be used t o maintain the haematologic response. This therapeutic protocol associ ated with drug monitoring seems promising and the side effects should not limit its use because of the severity of the underlying disease.