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Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone.

Publication ,  Journal Article
Doney, K; Pepe, M; Storb, R; Bryant, E; Anasetti, C; Appelbaum, FR; Buckner, CD; Sanders, J; Singer, J; Sullivan, K
Published in: Blood
May 15, 1992

Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia were entered into a prospective, randomized, two-arm treatment study comparing antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone. There were no differences between the two groups when comparing age, sex, etiology of aplasia, disease duration, severity of aplasia, or pretherapy granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete, partial, or minimal responses compared with 15 of 31 patients (48%) who received HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group and 47% for patients in the HDM group (P = .99). Causes of death included hemorrhage, infection, evolution to acute leukemia, and complications of subsequent bone marrow transplantation. Long-term complications included paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a significant difference in toxicity, response rate, or survival for patients treated with ATG, oxymetholone, and LDM compared with patients who received ATG, oxymetholone, and HDM.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

May 15, 1992

Volume

79

Issue

10

Start / End Page

2566 / 2571

Location

United States

Related Subject Headings

  • Time Factors
  • Prospective Studies
  • Probability
  • Oxymetholone
  • Methylprednisolone
  • Male
  • Immunosuppression Therapy
  • Immunology
  • Humans
  • Granulocyte-Macrophage Colony-Stimulating Factor
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Doney, K., M. Pepe, R. Storb, E. Bryant, C. Anasetti, F. R. Appelbaum, C. D. Buckner, J. Sanders, J. Singer, and K. Sullivan. “Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone.Blood 79, no. 10 (May 15, 1992): 2566–71.
Doney K, Pepe M, Storb R, Bryant E, Anasetti C, Appelbaum FR, Buckner CD, Sanders J, Singer J, Sullivan K. Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone. Blood. 1992 May 15;79(10):2566–2571.

Published In

Blood

ISSN

0006-4971

Publication Date

May 15, 1992

Volume

79

Issue

10

Start / End Page

2566 / 2571

Location

United States

Related Subject Headings

  • Time Factors
  • Prospective Studies
  • Probability
  • Oxymetholone
  • Methylprednisolone
  • Male
  • Immunosuppression Therapy
  • Immunology
  • Humans
  • Granulocyte-Macrophage Colony-Stimulating Factor