TREATMENT OF APLASTIC-ANEMIA WITH ANTITHYMOCYTE GLOBULIN, CYCLOSPORINE-A, METHYLPREDNISOLONE, DANAZOLE AND RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR

The main purpose of the present study was to determine the response ra te to immunosuppressive therapy combined with recombinant human granul ocyte-colony stimulating factor (rhG-CSF) and its efficacy for prevent ing infections in patients with severe aplastic anemia. The treatments included one course of antithymocyte globulin, cyclosporin A, methylp rednisolone, danazole and rhG-CSF. Three patients had very severe apla stic 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 respo nse rate at 6 months was 83.3%. All patients achieved an absolute neut rophil count of greater than 1.0 X 10(9)/L within 40 days. All patient s with a complete response are transfusion-free and doing well. All fi ve patients are currently alive and have not had any episode of infect ion for 17-53 months. The results of the study indicate that this ther apy may improve the poor prognosis of young patients with severe aplas tic anemia. It has a good response rate and induces a rather rapid inc rease in the neutrophil count, which protects against life-threatening bacterial and fungal infections.