Combined immunosuppressive therapy in aplastic anaemia

Fifteen patients with aplastic anaemia (AA) were treated combined immunosuppressive treatment (9 of them had severe, the others had less severe AA). Cyclosporin A(CsA) was given as 12 mg/kg/daily intravenous infusions for 90 days with serum levels being monitored weekly by radioimmunoassay. Antilymphocyte globulin serum (ALG) was administered by intravenous infusion through eight hours at a dosage of 20 mg/kg/daily for eight days. Methylprednisolone (MP) was given orally as 5 mg/kg/daily, tapered every three days, for 29 days. Complete remission (CR) was observed in five severe AA patients and two less severe AA patients with therapy. Partial remission (PR) was observed in one severe AA and two less severe AA patients. No remissions were reached in four patients, two of whom had severe AA, the others had less severe AA. Replace was observed in two patients as sixth and ninth month. Haemolysis occurred in one patient and MP was started. Only one patient died during the treatment because of infection due to febrile neutropaenia. Toxicities were reversible. Combined immunosuppressive treatment may be the treatment of choice for patients who are not eligible for bone marrow transplantation.