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Oral cyclosporin-A is effective treatment for untreated and also for previously immunosuppressed patients with severe bone marrow failure*

Authors :
Wolfgang Hinterberger
Heinz Seewann
Klaus Lechner
Paul Höcker
Margareta Hinterberger-Fischer
Source :
European Journal of Haematology. 43:136-142
Publication Year :
2009
Publisher :
Wiley, 2009.

Abstract

16 patients with transfusion-dependent, life-threatening bone marrow failure (14 with severe aplastic anaemia, 1 with systemic lupus erythematosus and 1 with pure red cell aplasia) were treated with cyclosporin-A (Cy-A) after either lack of response to conventional immunosuppression with antithymocyte-globulin/high-dose methylpred-nisolone for 95 to 1190 days (median 186.5) (group I, 8 patients) or as a primary treatment due to ineligibility for conventional immunosuppression (group II, 8 pat.). Cyclosporin-A was given orally to maintain trough levels of 200 to 300 ng/ml (RIA). In group I, 6 out of 8 patients responded 30 to 480 d (median 53) and are currently alive 627 to 1482 d (median 731) after initiation of Cy-A, respectively. In 3 of the responders Cy-A has been withdrawn, without relapse. In group II, 5 of 8 patients responded 26 to 170 d (median 63) and are currently alive 142 to 697 (median 420) d following initiation of Cy-A, respectively. These data indicate a place for cyclosporin-A in the management of patients with life-threatening bone marrow failure in whom a) immunosuppressive therapy with antithymocyte-globulin and high-dose methylprednisolone had failed and b) who are not candidates for vigorous immunosuppression or bone marrow transplantation, for medical or other reasons.

Details

ISSN :
16000609 and 09024441
Volume :
43
Database :
OpenAIRE
Journal :
European Journal of Haematology
Accession number :
edsair.doi.dedup.....36b2e9db0a19c771abc2019f65b65fc8
Full Text :
https://doi.org/10.1111/j.1600-0609.1989.tb00269.x