[Effectiveness of the treatment of severe aplastic anemia (splenectomy and immunosuppression)]

The authors appraise the efficacy of the treatment of severe aplastic anemia by splenectomy, antilymphocyte globulin and cyclophosphamide. A total of 120 patients were placed under observation. Of these, 103 patients had a severe disease pattern, one hundred and 112 patients with aplastic anemia including 96 with a severe pattern were subjected to splenectomy. Of the 112 splenectomized patients, 78 (69.6%) are alive. Of the 96 patients with severe aplasia, 60 patients (62.5%) are alive. Of 43 deceased patients, 7 had been admitted to the hospital 2-12 days before death and had not been subjected to splenectomy. Three patients died shortly after splenectomy, 8 patients died at the second month after operation. During the first 6 months after operation 20% of the operated patients died, whereupon 10 more per cent of the patients died for 5 months. The patients who survived 10 months may happen to develop a complete or partial remission. Complete remission was attained in 18.8% of the patients, almost complete recovery in 17.7% of the operated, considerable improvement of the estimates was attained in 17.7% of the patients. Antilymphocyte globulin was administered to 23 splenectomized patients. The remission was attained in 6 patients, and 8 more patients improved. If the patients did not respond to the treatment with antilymphocyte globulin, or if they developed relapses, the authors administered cyclophosphamide. Of the 15 patients, 9 responded to the treatment (5 patients improved, remission was attained in 4 patients, 3 of whom are in a state of remission until now). On the 15 patients treated with cyclophosphamide 12 patients have been alive for not less that 2 years.