A multicenter randomized study comparing cyclosporin-A alone and antithymocyte globulin with prednisone for treatment of severe aplastic anemia

Gluckman, Éliane; Espérou-Bourdeau, H; Baruchel, André; Boogaerts, M; Brière, J; Donadio, D; Leverger, Guy; Leporrier, M; Janvier, Maud; Michallet, Mauricette; Stryckmans, Pierre

doi:10.1016/0896-8411(92)90043-p

Cited by 24 publications

(29 citation statements)

References 27 publications

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“…[50][51][52] ATG restores hematopoiesis in many patients with aplastic anemia. 26,27,53 In a multicenter Table 3 Responses by diagnosis in 31 patients treated with ATG-cyclosporine and prednisone…”

Section: Discussionmentioning

confidence: 99%

“…26,29 Fever and urticaria are common adverse events occurring on the first and second day of administration of ATG. Corticosteroids ameliorate serum sickness, 49 as it occurs less frequently with regimens incorporating prednisone with or without cyclosporine, 53 than with ATG alone. 38,49,59 Transaminitis and renal insufficiency are common adverse events with the use of cyclosporine.…”

Section: Atg In Mdsmentioning

confidence: 99%

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Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes

et al. 2003

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Section: Discussionmentioning

confidence: 99%

Section: Atg In Mdsmentioning

confidence: 99%

Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes

et al. 2003

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“…Antithymocyte globulin (ATG) and cyclosporine A (CyA) are immunosuppressive drugs generally used for AA and had an equivalent efficacy in terms of hematologic response rate and a survival rate. 1 It has been also demonstrated that the combination of ATG and CyA is superior to ATG or CyA alone in terms of hematologic response. 2,3 Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor that mainly stimulates the proliferation and differentiation of granulocyte precursors; however, a stimulatory effect of G-CSF on multipotential hematopoietic stem cells has also been demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Treatment of severe aplastic anemia with antithymocyte globulin and cyclosporin A with or without G-CSF in adults: a multicenter randomized study in Japan

Teramura

Kimura

Iwase

et al. 2007

Blood

105

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We report the results of a randomized study to elucidate whether addition of granulocyte colony-stimulating factor (G-CSF) to immunosuppressive therapy is valuable for the treatment of severe aplastic anemia (SAA) in adults. A total of 101 previously untreated patients (median age, 54 years; range, 19 to 75 years) were randomized to receive antithymocyte globulin (ATG) and cyclosporin A (CyA) (G-CSF؊ group) or ATG, CyA, and G-CSF (G-CSF؉ group). In the G-CSF؉ group, the hematologic response rate at 6 months was higher (77% vs 57%; P ‫؍‬ .03) than in the G-CSF؊ group. No differences were observed between the groups in terms of the incidence of infections and febrile episodes. There were no differences between the G-CSF؊ group and the G-CSF؉ group in terms of survival (88% vs 94% at 4 years), and the development of myelodysplastic syndrome (MDS)/acute leukemia (AL) (1 patient vs 2 patients). However, the relapse rate was lower in the G-CSF؉ group compared with the G-CSF؊ group (42% vs 15% at 4 years; P ‫؍‬ .01). Further follow-up is required to elucidate the role of G-CSF in immunosuppressive therapy for adult SAA. (Blood.

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“…At 3 months, OR was 7 (14 %) with 6 (12 %) PR and one (2 %) CR was achieved. Gluckman et al [2] had shown CR ? PR response rate of 16 % at 3 months.…”

mentioning

confidence: 99%

“…In a study by Gluckman et al [2], cyclosporine was as effective as antithymocyte globulin (ATG) in patients with severe aplastic anemia (SAA). Compared to ATG, cyclosporine is less expensive, administered orally on an outpatient basis, readily available and less toxic.…”

mentioning

confidence: 99%

Outcome of Cyclosporine Monotherapy in Patients of Aplastic Anemia: Experience of a Tertiary Care Hospital in Eastern India

Mandal

Baul

Dolai

et al. 2016

Indian J Hematol Blood Transfus

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Introduction Immune suppression is a crucial pillar for treatment of aplastic anemia. Cyclosporine monotherapy is an easily available, affordable therapeutic option with good safety profile. Methods and Materials This prospective study was conducted over a period of 2 years from June 2012 to July 2014. The diagnosis and response to treatment of aplastic anemia was established as per published criteria. Follow up was done at 3 and 6 months in order to assess the response. Results 57 patients of acquired aplastic anemia with median age of 37 years (6 to 81 years) were included in the study. 35 (62 %) cases were severe aplastic anemai, 16 (28 %) non severe aplastic anemia and 6 (10 %) were very severe aplastic anemia. At 3 months overall response rate (OR) was 7 (14 %) and at 6 months the OR rate of 11 (19.6 %) was achieved. Transiently raised creatinine, liver function abnormality and gum hypertrophy were the main side effects observed in this cohort. Conclusion Oral cyclosporine monotherapy at dose of 5 mg/kg/day is a relatively safe treatment option for resource poor patients with aplastic anemia.

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A multicenter randomized study comparing cyclosporin-A alone and antithymocyte globulin with prednisone for treatment of severe aplastic anemia

Cited by 24 publications

References 27 publications

Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes

Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes

Treatment of severe aplastic anemia with antithymocyte globulin and cyclosporin A with or without G-CSF in adults: a multicenter randomized study in Japan

Outcome of Cyclosporine Monotherapy in Patients of Aplastic Anemia: Experience of a Tertiary Care Hospital in Eastern India

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