Treatment of severe aplastic anemia with sequential immunosuppression

A. M. Marmont, A. Bacigalupo, M. T. van Lint, F. Frassoni, M. Risso, R. Cerri, E. Rossi, E. E. Damasio, G. Santini, M. Carella

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Abstract

Forty-two patients with severe aplastic anemia (SAA) were treated with immunosuppressive therapy (IS) consisting of one or more courses of the following regimens: a) high dose bolus 6 methylprednisolone (BMPr); b) horse antilymphocytic globulin (HALG); c) rabbit ALG (RALG); d) ALG followed by the infusion of haploidentical marrow (ALG ± BM); e) BMPr in combination with HALG; f) ALG in combination with androgens. All patients received one initial course of IS: 16 (38%) showed hematologic reconstitution and required no further transfusions, of 26 refractory patients 4 died, and 22 received a second course of IS 60 days after the first course. Of these 22, 6 (27%) responded, and of the 16 refractory patients, 9 died, and 7 received a third course of IS 60 days after the second course. Two of these responded (28%), 3 died and 2 are alive but pancytopenic. The overall response rate is 24/42 patients (57%): all of these patients are transfusion independent 6-60 months post-treatment, and 17 are off maintenance therapy with low dose steroids. The actuarial 5 year survival is currently 60%; 13/26 surviving patients have been followed for more than 3 years. The present study confirms that over 50% of patients with SAA can recover from their aplasia following IS treatment, and this is of relevance for patients who can not be offered a bone marrow transplant.

Original languageEnglish
Pages (from-to)856-865
Number of pages10
JournalExperimental Hematology
Volume11
Issue number9
Publication statusPublished - 1983

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Aplastic Anemia
Immunosuppression
Immunosuppressive Agents
Therapeutics
Globulins
Methylprednisolone
Horses
Bone Marrow
Androgens
Steroids
Rabbits
Transplants
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Cell Biology
  • Genetics
  • Hematology
  • Oncology
  • Transplantation

Cite this

Treatment of severe aplastic anemia with sequential immunosuppression. / Marmont, A. M.; Bacigalupo, A.; van Lint, M. T.; Frassoni, F.; Risso, M.; Cerri, R.; Rossi, E.; Damasio, E. E.; Santini, G.; Carella, M.

In: Experimental Hematology, Vol. 11, No. 9, 1983, p. 856-865.

Research output: Contribution to journalArticle

Marmont, AM, Bacigalupo, A, van Lint, MT, Frassoni, F, Risso, M, Cerri, R, Rossi, E, Damasio, EE, Santini, G & Carella, M 1983, 'Treatment of severe aplastic anemia with sequential immunosuppression', Experimental Hematology, vol. 11, no. 9, pp. 856-865.
Marmont, A. M. ; Bacigalupo, A. ; van Lint, M. T. ; Frassoni, F. ; Risso, M. ; Cerri, R. ; Rossi, E. ; Damasio, E. E. ; Santini, G. ; Carella, M. / Treatment of severe aplastic anemia with sequential immunosuppression. In: Experimental Hematology. 1983 ; Vol. 11, No. 9. pp. 856-865.
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