[Treatment of severe aplastic anemia with a cyclosporin-corticosteroid combination]

Four patients with severe aplastic anemia were treated with a combination of cyclosporin (5 mg/kg/day) and steroids (prednisone 0.2-0.8 mg/kg/day 3/4 days). A positive response (transfusions stopped, granulocytes greater than 1500/mm3, thrombocytes greater than 50,000/mm3) was achieved in three of these patients. The therapy had a rapid effect on reticulocytes and granulocytes (7-14 days) while platelet numbers took longer to correct (2-4 months). All patients presented signs of dyserythropoiesis with macrocytosis. Side effects of therapy were minor (tremor, water retention, gynecomastia, hirsutism). In this series, the combination of cyclosporin with steroids appears to be an effective treatment for severe aplastic anemia with a more rapid result and better tolerance in comparison to antilymphocyte serum.