COMBINED IMMUNOSUPPRESSIVE THERAPY IN APLASTIC-ANEMIA

Fifteen patients with aplastic anaemia (AA) were treated with combined immunosuppressive treatment (9 of them had severe, the others had les s severe AA). Cyclosporin A(CsA) was given as 12 mg/kg/daily intraveno us infusions for 90 days with serum levels being monitored weekly by r adioimmunoassay. Antilymphocyte globulin serum (ALG) was administered by intravenous infusion through eight hours at a dosage of 20 mg/kg/da ily for eight days. Methylprednisolone (MP) was given orally as 5 mg/k g/daily, tapered every three days, for 29 days. Complete remission (CR ) was observed in five severe AA patients and two less severe AA patie nts with therapy. Partial remission (PR) was observed in one severe AA and two less severe AA patients. No remissions were reached in four p atients, two of whom had severe AA, the others had less severe AA. Rel apse was observed in two patients at sixth and ninth month. Haemolysis occurred in one patient and MP was started. Only one patient died dur ing the treatment because of infection due to febrile neutropaenia. To xicities were reversible. Combined immunosuppressive treatment may be the treatment of choice for patients who are not eligible for bone mar row transplantation.