Immunosuppressive triple-therapy using Tymogam庐 in idiopathic aplastic anemia

[摘要] Introduction: immunosuppressive treatment with antithymocyte or antilymphocyte globulin and cyclosporin A is considered the standard treatment for patients with very severe or severe idiopathic aplastic anemia who do not have the possibility of progenitor hematopoietic transplantation. Objective:to evaluate the responses to immunosuppressive treatment using Thymogam® in adult patients with idiopathic aplastic anemia.Material and methods: a descriptive study was performed in 26 patients older than 18 years with diagnosis of idiopathic aplastic anemia, attended at the Institute of Hematology and Immunology from January 2000 to April 2012, who received antithymocyte globulin (Thymogam®) as part of immunosuppressive treatment. Results: patients were classified as very severe (14) and severe ( 12). The median age was 36 years old (range 18 - 74 years). In the first six months after the start of treatment, 73 % of patients obtained some kind of response and 15 of them (57,6 %) had a complete response, which was more frequent in the group of patients with less of 25 years of age. The percentage of relapse was 26,3 %. The more frequent adverse reactions were fever, arterial hypertension, tremors and sweatiness. The main adverse reactions were severe bleeding and infections. One patient developed acute myeloid leukemia. Overall survival at 5 years was 73 %.Conclusion:thymogam® is one therapeutic option in the immunosuppressive treatment in patients with very severe or severe idiopathic aplastic anemia.

[学科分类] 生理学与病理学

[关键词] very severe or severe idiopathic aplastic anemia;immunosuppressive treatment;Thymogam®