Androstane Therapy of Aplastic Anaemia

Duarte, Lorenzo; Sandoval, R López; Esquivel, F; Sánchez-Medal, L

doi:10.1159/000208508

Cited by 32 publications

(6 citation statements)

References 4 publications

(7 reference statements)

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“…No evidence of pulmonary tuberculosis was found on chest X-ray in any of the cases. With the exception of case 5, all patients were treated for 4-10 weeks with re peated blood transfusions and high doses of oxy- - [7,12] and helps only mild to moderate disease [8]. Besides, peripheral blood counts remained more or less the same and in most instances actually deteriorated in spite of high doses of oxymetholone.…”

Section: Methodsmentioning

confidence: 99%

Fetal Liver Transplantation in Aplastic Anemia

et al. 1979

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Fetal liver transplantation was attempted in 7 patients with aplastic anemia. 4 of these patients showed a partial response as evidenced by decrease in blood transfusion requirements and increase in the peripheral blood counts and hematopoietic cells in the bone marrow. Bone marrow culture studies revealed evidence of a temporary mixed lymphoid chimerism (cases 1 and 3). While case 1 lived for 16 months, case 3 is surviving at 17 months. None of the patients showed apparent graft-versus-host disease. Increased incidence of infections was noticed. Possible causes for the same are discussed. 3 patients failed to respond. Fetal liver transplant may be of therapeutic value in management of aplastic anemia.

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Section: Methodsmentioning

confidence: 99%

Fetal Liver Transplantation in Aplastic Anemia

et al. 1979

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“…Various authors have attempted to predict the likely course of the disease; some have found an increased reticulocyte count of favourable prognostic significance (Durate et al, 1972;Sanchez-Medal et al, 1969;Lewis, 1965). Bloom and Diamond (1968) regarded a raised alkali-resistant haemoglobin level as a hopeful prognostic sign.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Aplastic anaemia: an analysis of 174 patients

Geary

1980

Postgraduate Medical Journal

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Summary The authors summarize their experience with 174 patients with aplastic anaemia (AA) with particular reference to course, prognostic factors, conversion to other blood disorders, treatment and outcome. Aplastic anaemia was defined as pancytopenia and a hypocellular marrow at some time during the illness. Seven patients terminated with acute leukaemia, 8 developed haematological features of sideroblastic anaemia and 5 showed a red cell membrane defect commonly found in paroxysmal noctural haemoglobinuria. Complete recovery occurred in only 4 patients; 70 others showed a partial remission with some residual haematological abnormality in peripheral blood. Eighteen of these had spontaneous remission. Remission was brief in 27 patients who died; only 32 patients remained in partial remission. Twenty-five per cent. of the patients with AA run an acute course and die within 6 months of the time of diagnosis. The remainder run a subacute or chronic course, punctuated in some cases by a transient remission, but in others by a conversion to other related haematological disorders. An acute course is suggested by a rapid onset of symptoms, a falling neutrophil count, a haemoglobin level less than 5 g/dl and a very low platelet count. A chronic course is likely in those patients who have a slow onset of symptoms, a stable neutrophil count and a Hb level in excess of 5 g/dl. The authors’ experience shows that the disease runs either of the 2 courses irrespective of the supportive therapy.

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“…The studies published by Sánchez-Medal in the mid-1970s described how different types of androgens could improve cytopaenia in aplastic anaemia, mainly in patients with moderate disease. 14,15 Interest in the therapy gradually faded, until it was eventually ignored in most therapeutic guidelines. 13,16 Although evidence in the literature has consistently shown the scant beneficial therapeutic effect of androgens, most physicians continue to use it regularly, either in monotherapy or in combination with an immunosuppressant.…”

Section: Discussionmentioning

confidence: 99%

Androgens added to immunosuppressive regimen in patients with aplastic anaemia. A retrospective study

Ramos-Peñafiel

Ferrer-Argote

Trejo-Ayala

et al. 2015

Revista Médica Del Hospital General De México

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Background: Androgens have been used to treat bone marrow failure syndromes such as aplastic anaemia (AA) since the 1970s, and are currently used as adjuvants to other treatment regimens. Objective: To determine the efficacy and response time of androgens in the treatment of AA. Materials and methods: A retrospective, analytical-observational nested study in a cohort of patients with AA. The study was conducted from January 2006 to December 2013. Results: A total of 63 patients with a mean age of 47 (18---83) years were included in the study. Out of 27 patients in full remission, 17 received some type of immunosuppressant combined with androgens. The use of more than 2 immunosuppressants did not significantly improve response times (p = 0.311, 95% CI). Mean response time was 725 (331---1119) days; 4-year survival rate was 86%. Conclusions: Improved immunosuppressant response rates with adjuvant androgens were mainly observed in patients with severe AA. Anemia aplásica; Andrógenos; Resultado del tratamiento; Inmunosupresión; Estudio de cohorte Cohorte retrospectiva de la adición de andrógenos al régimen inmunosupresor en pacientes con anemia aplásica ResumenAntecedentes: Desde los sesenta se utilizan andrógenos para tratar síndromes de falla medular, como la anemia aplásica (AA), actualmente son complemento a otros tratamientos. Objetivo: Establecer la eficacia y tiempo de respuesta al tratamiento con andrógenos en AA. Material y Métodos: Estudio retrospectivo, observacional-analítico anidado en la cohorte de pacientes portadores de AA durante enero 2006 a diciembre 2013.Resultados: Se estudiaron 63 pacientes, con edad media de 47 (18---83) años. De 27 pacientes (42.9%) que integraron remisión completa, 17 recibían algún inmunosupresor en conjunto con andrógenos. Usar más de 2 inmunosupresores elevó no significativamente (p = 0.311, 95%IC) las respuestas. La media de respuesta fue de 725 (331---1,119) días. La supervivencia a 4 años fue del 86%. Conclusiones: Adicionar andrógenos mejoró la tasa de respuesta a los inmunosupresores principalmente en pacientes con AA muy severa.

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Androstane Therapy of Aplastic Anaemia

Abstract: Androstane therapy in 34 new cases of aplastic anaemia together with the follow-up in 33 cases previously reported is evaluated. Thenew cases were of the acquired variety and had a hypoplastic marrow. Remission rate was 50%.

Cited by 32 publications

References 4 publications

Fetal Liver Transplantation in Aplastic Anemia

Fetal Liver Transplantation in Aplastic Anemia

Aplastic anaemia: an analysis of 174 patients

Androgens added to immunosuppressive regimen in patients with aplastic anaemia. A retrospective study

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