TRILINEAGE RECOVERY BY COMBINATION THERAPY WITH RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR AND ERYTHROPOIETIN IN PATIENTS WITHAPLASTIC-ANEMIA AND REFRACTORY-ANEMIA

Ten patients with aplastic anemia (AA) and seven patients with refract ory anemia (RA) were treated with recombinant human granulocyte colony -stimulating factor (rhG-CSF) and erythropoietin (rhEpo) in combinatio n. rhG-CSF (5-20 mu g/kg) and rhEpo (120-720 U/kg) were administered b y s.c. injection three times a week for at least six months, and the a dministration was continued as maintenance therapy for as long as poss ible when hematological responses were observed. Six (60%) of the ten AA patients and four (58%) of the seven RA patients showed multilineag e responses. Of these responders, six patients achieved trilineage rec overy. While all of the responders were dependent on red blood cell tr ansfusions and eight of them required platelet transfusions before tre atment, they now no longer need transfusions of either red blood cells or platelets. A median treatment duration of 9 (range 1 to 28) months was required to achieve multilineage recovery. The responders showed an ability to maintain the multilineage recovery for 9+ to 47+ months and to tolerate long-term treatment. These results indicate that the l ong-term treatment with rhG-CSF and rhEpo may benefit a substantial pe rcentage of patients with AA and RA and provide an optional therapy fo r these patients.