TREATMENT OF APLASTIC-ANEMIA WITH A MONOCLONAL-ANTIBODY DIRECTED AGAINST THE INTERLEUKIN-2 RECEPTOR

Severe aplastic anemia (SAA) has been related in most cases to underly ing autoimmune conditions. Various immunosuppressive regimens have bee n recommended in the absence of an HLA-identical bone marrow donor. Pr ednisolone, antithymocyte globulin, and cyclosporin A have been shown to be effective. This report describes the successful treatment of a 2 3-year-old woman suffering from severe aplastic anemia who had become multiresistant against previously administered immunosuppressive agent s, using a monoclonal IL-2-receptor blocking antibody. The patient res ponded within 4 weeks. The time to the next relapse was 8 months; howe ver, another remission with a second course of horse-antithymocyte glo bulin was achieved and has been maintained for 27 months to date with low doses of cyclosporin A. Although this is an anecdotical report, IL -2-receptor blockade using a monoclonal antibody might be considered a s a further alternative in multi-resistant SAA, perhaps increasing the susceptibility to further immunosuppressive trials.