TREATMENT OF SEVERE APLASTIC-ANEMIA WITH AN IMMUNOSUPPRESSIVE AGENT PLUS RECOMBINANT HUMAN GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTORAND ERYTHROPOIETIN

To evaluate the therapeutic potential of hematopoietic growth factors (HGFs) during immunosuppressive treatment (IST) of severe aplastic ane mia (SAA), 38 patients with newly diagnosed SAA received IST alone (gr oup I), or IST plus recombinant human erythropoietin and granulocyte-m acrophage colony-stimulating factor (rhEPO + rhGM-CSF) (group II). Ele ven patients in each group received antilymphocyte globulin (ALG) for IST, and eight patients in each group received cyclosporine (CSA). Com plete remission rates at one year were 26% and 74% for group I and gro up II patients, respectively. The ALG-treated subgroup showed the grea test differences between treatments. Compared with patients receiving ALG alone, patients treated with ALG plus HGFs had significantly bette r one-year survival (100% vs. 54.5%, P < 0.05), complete remission rat es (91% vs. 36%, P < 0.05), more rapid and complete hematologic recove ry, greater reductions in transfusion requirements, and lower infectio n rates. The data suggest a potential role for rhEPO + rhGM-CSF therap y in SAA patients receiving IST. (C) 1998 Wiley-Liss, Inc.