Immunosuppressive therapy for aplastic anemia: a single-center experience from western India

• DOI: 10.1007/s00277-018-3487-2
• Publication Date: 2018-09-01T05:56:16Z
• Authors: Sandip Shah; Preetam Jain; Kamlesh Shah; Kinnari Patel; Sonia Parikh; Apurva Patel; Harsha Panchal; Asha Anand
• Keywords: Aplastic anemia; Hematology; Salvage therapy; Immunosuppression

Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine A (CsA) is the first-line for acquired aplastic anemia (AA) in those not suitable bone marrow transplant. Horse ATG (hATG) preferred this purpose, but its use often impeded by shortages costs. Being a rare disease, there limited data on therapy. This study aimed to evaluate large cohort of AA patients from western India. We retrospectively analyzed who received an indigenous preparation hATG along CsA as treatment, between 2012 2015, at our center evaluated response, survival, occurrence adverse events. The response was further assessed separately adults children. During period, 91 (4 non-severe, 57 severe 30 very severe) were treated IST. At 2 years, 23.5% 39.1% children showed complete overall 68.1% cases became transfusion independent. More than half developed febrile neutropenia while roughly one sixth gum hypertrophy and/or hypertension. Two had clonal evolution. Mortality rate calculated be 31%; most common causes death infection intracranial hemorrhage. results substantiate effectiveness IST AA, using inexpensive CsA.