Acquired Aplastic Anaemia, Other Acquired Bone Marrow Failure Disorders and Dyserythropoiesis

Gordon‐Smith, E. C.; Marsh, Judith

doi:10.1002/9780470987056.ch13

Postgraduate Haematology 2005

DOI: 10.1002/9780470987056.ch13

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Acquired Aplastic Anaemia, Other Acquired Bone Marrow Failure Disorders and Dyserythropoiesis

E. C. Gordon‐Smith¹,

Judith Marsh²

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2016

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Cited by 2 publications

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“…The high incidence of aplastic anaemia in countries of South-east Asia including Bangladesh (3 to 4 times than Europe) does not reflect a genetic or racial predisposition. More likely, the high incidence is related to the greater prevalence of viral infection particularly hepatitis, more widespread use of potentially toxic antibiotic and perhaps to the wide use of industrial and agricultural chemicals including pesticides without adequate protection 3,4,5 . So, this geographic variation is probably mainly environmental rather than genetic.…”

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A Prospective Study on Response of Immunosuppressive Therapy with Cyclosporine and Prednisolone in Acquired Aplastic Anaemia

Islam

Hossain

et al. 1970

J Dhaka Med Coll

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Context: A randomized prospective study was done to see the effect of therapy with cyclosporine and prednisolone in patients with idiopathic aplastic anemia. Methods: A total of 40 patients were included in this study .We use cyclosporine 6mg/kg/ day and prednisolone 30 mg /day for a period 6 months. The study was done during the period of July 2005 to October 2006. In the study population, out of 40 patients, 26 were male and 14 were female. 2 patients died early in the treatment and 4 patients transformed into acute leukemia. The rest 34 patients completed therapy for 6 months. Results: Among the 34 patients, 22 patients responded to therapy and 12 patients were nonresponders. According to severity, population distribution was as follows: 12 (35.30%) patients were non-severe AA, 19 (55.88%) patients were severe AA and 3 (8.82%) patients were very severe AA. Out of 22 patients (responders), 7 (31.82%) patients start to respond at 3rd month, 5 (22.73%) patients at 4th month, 8 (36.36%) patients at 5th month and 2 (9.09%) patients were very late to respond; they respond at 6th month. At the end of 6th month trial, 7 (20.59%) patients had complete response, 15 (44.12 %) patients had partial response and 12 (35. 29%) patients were non-responders; overall response rate was 64.71%. The adverse effects of the therapy were found e.g. weight gain in 100%, hypertension in 26.47%, increased serum creatinine in 38.23%, hyperglycemia in 20.58% and infection due to immunosuppression in 14.71%. Conclusion: Combination of cyclosporine and prednisolone therapy merits further study as primary treatment for aplastic anemia in patients who are not able to undergo bone marrow transplantation. Key words: Aplastic anaemia; immunosuppressive therapy; combination of cyclosporine and prednisolone. DOI: 10.3329/jdmc.v19i2.7074J Dhaka Med Coll. 2010; 19(2) : 80-85

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confidence: 99%

A Prospective Study on Response of Immunosuppressive Therapy with Cyclosporine and Prednisolone in Acquired Aplastic Anaemia

Islam

Hossain

et al. 1970

J Dhaka Med Coll

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Aplastic Anemia in Egypt: Current Situation and Future Prospective

Khaled¹

2016

AJIM

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Aplastic anemia (AA) is a hypoproliferative anemia that led to a significant morbidity and mortality. Recently, dramatic improvement in prognosis of AA was achieved; this was in part due to advances in immunosuppressive therapy and HSCT. Nevertheless, AA is still one of the most challenging hematological disorders that could face a hematologist. This study was conducted at Assiut University Hospital (AUH), Assiut, Egypt to evaluate current situation and future prospective of AA. 63 patients with AA were prospectively enrolled in the study; they were admitted at the Hematology unit, AUH in the period 1stJan 2011 to Feb 2012, a 38 patients with iron deficiency anemia (IDA) were included for comparison. Patients' demographic and clinical data were collected through medical history and clinical examination. Both direct and indirect health care costs of anemia were assessed Direct parameters included doctors' and hospital fees, costs of laboratory investigations, medication fees and costs of HSCT or any procedure. Indirect costs included travelling expenses and earning losses. Social burden of anemia was estimated by anemia related morbidity and mortality. Data were analyzed with SPSSV.17, results showed that AA affected young age group with mean age 30.89±13.39 years, without sex predilection, acquired AA was more common than idiopathic (55.6% vs. 44.4%), however mortality was higher in idiopathic AA (46.2%). Causes of aplasia were exposure to chemicals, drugs and hepatitis in order. Only 63.5% of AA were admitted once and 47.6% in general ward, the mean hospital days for patients with AA was 17.73±11.10, compared to 8.32±6.69 in IDA, P=0.000, also higher socio-economic burden of AA was found compared with IDA. These results denoted that management of AA is still ineffective, and that there is a definite need for a strict plan to prevent incidence of AA, particularly in developing countries where effective management of AA is too expensive and relatively unavailable.

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Acquired Aplastic Anaemia, Other Acquired Bone Marrow Failure Disorders and Dyserythropoiesis

Cited by 2 publications

References 37 publications

A Prospective Study on Response of Immunosuppressive Therapy with Cyclosporine and Prednisolone in Acquired Aplastic Anaemia

A Prospective Study on Response of Immunosuppressive Therapy with Cyclosporine and Prednisolone in Acquired Aplastic Anaemia

Aplastic Anemia in Egypt: Current Situation and Future Prospective

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