Treatment of aplastic anemia with antithymocyte globulin, high-dose corticosteroids, and androgens.

Published

Journal Article

A total of 46 patients with aplastic anemia (34 severe; 12 moderate) were treated with antihuman thymocyte globulin (ATG), high-dose methylprednisolone, and oxymetholone. Early symptoms of ATG toxicity included fever, rash, and bronchospasm. Signs of serum sickness also developed in 23 patients. Complications associated with high doses of steroids were hyperglycemia, hypertension, fluid retention, gastrointestinal hemorrhage, and aseptic necrosis of the hip. Other morbidity possible associated with steroid administration included seizures, arrhythmias, and headache with papilledema. Studies of elevated liver function necessitated discontinuation of androgen therapy in eight patients. A complete or partial hematological response was noted in 19 patients (41%). Of these, three have had recurrent cytopenias, of whom one has developed a myelodysplastic syndrome. There are currently 34 patients surviving, and 12 who have died. Actuarial survival at three years is 65%. These response and survival data are comparable to those of previous trials using ATG and androgens without high-dose steroids. A prospective, randomized trial is needed to determine whether the addition of high-dose corticosteroids to ATG does significantly increase the rate and frequency of response in order to justify the toxicity of this additional immunosuppressive therapy in the treatment of aplastic anemia.

Full Text

Duke Authors

Cited Authors

  • Doney, K; Storb, R; Buckner, CD; McGuffin, R; Witherspoon, R; Deeg, HJ; Appelbaum, FR; Sullivan, KM; Thomas, ED

Published Date

  • March 1, 1987

Published In

Volume / Issue

  • 15 / 3

Start / End Page

  • 239 - 242

PubMed ID

  • 3493172

Pubmed Central ID

  • 3493172

International Standard Serial Number (ISSN)

  • 0301-472X

Language

  • eng

Conference Location

  • Netherlands