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[Immunomodulating treatment of severe aplastic anemia in adults]
J M Tangen1, Wisløff, O K Andersen
1Hematologisk avdeling, Medisinsk klinikk, Ullevål sykehus, Oslo.
Immune modulating therapy has greatly improved the prognosis in aplastic anaemia, but the response to treatment varies considerably. We describe eight patients who were treated for severe aplastic anaemia. Antithymocyte globulin was given as first line treatment, followed by cyklosporine A if the patient failed to respond. Seven patients entered complete remission, but two of these relapsed later. Both developed paroxysmal nocturnal haemoglobinuria. One patient failed to respond to therapy. She died of bone marrow failure and haemochromatosis 12 months after start of therapy. Immune modulating therapy is discussed in relation to bone marrow transplantation, which is the alternative therapy for younger patients.
Immune modulating therapy has greatly improved the prognosis in aplastic anaemia, but the response to treatment varies considerably. We describe eight patients who were treated for severe aplastic anaemia. Antithymocyte globulin was given as first line treatment, followed by cyklosporine A if the patient failed to respond. Seven patients entered complete remission, but two of these relapsed later. Both developed paroxysmal nocturnal haemoglobinuria. One patient failed to respond to therapy. She died of bone marrow failure and haemochromatosis 12 months after start of therapy. Immune modulating therapy is discussed in relation to bone marrow transplantation, which is the alternative therapy for younger patients.