Abnormal cytogenetic clones in patients with aplastic anaemia: response toimmunosuppressive therapy

We report the response to immunosuppressive therapy with antithymocyte glob ulin (ATG) and cyclosporin or oxymetholone in 13 cases of aplastic anaemia (AA) with an abnormal cytogenetic clone detected at or sometime after diagn osis. Blood and bone marrow examination showed no distinctive morphological features of myelodysplasia (MDS) at diagnosis. Haematological response occ urred promptly in eight cases; the remainder responded after additional imm unosuppression with or without oxymetholone. Three patients had a late rela pse of AA, treated successfully by allogeneic bone marrow transplantation i n one; the others responded to oxymetholone. Transformation to MDS or acute leukaemia was not observed after a median follow-up of 4.1 years (range 1. 2-11.2). In four patients the cytogenetic clone disappeared after treatment .