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Annals of Hematology

, Volume 90, Issue 5, pp 523–527 | Cite as

Danazol as first-line therapy for aplastic anemia

  • José Carlos Jaime-PérezEmail author
  • Perla R. Colunga-Pedraza
  • Cynthia D. Gómez-Ramírez
  • César H. Gutiérrez-Aguirre
  • Olga G. Cantú-Rodríguez
  • Luz C. Tarín-Arzaga
  • David Gómez-Almaguer
Original Article

Abstract

Immunosuppressive therapy (IST) with anti-thymocyte globulin (ATG) plus cyclosporine A (CsA) is the standard treatment for aplastic anemia (AA) patients not eligible for allogeneic hematopoietic stem cell transplantation (HSCT). In the absence of ATG + CsA, androgens continue to be a treatment option. We documented the clinical evolution of AA patients treated with danazol instead of ATG + CsA. AA patients lacking both, human leukocyte antigen-matched donor and access to IST, were treated with danazol and modern support therapy and compared with those receiving a HSCT. Overall survival (OS), response rates, and death risk odds were calculated. Fifty AA patients were studied. Thirteen received a HSCT and 37 danazol and support therapy. Median daily dose of danazol was 400 mg (300 to 600 mg), administered during a median of 12 months. Five-year OS was higher for patients receiving HSCT (92%) compared to the danazol group (41%) (P = 0.001). Overall response rate was 46% (17/37) in the danazol-treated group and the median time to initial response was 3 months (1–27). Tendency to achieve remission was similar among severity groups (P = 0.094). The only adverse side effect recorded on the danazol group was an episode of gastrointestinal bleeding. No patient treated with danazol suffered clonal evolution of his/her disease. Although ATG plus CsA is the therapy of choice for AA patients without a donor when neither HSCT nor IST is available, danazol remains an acceptable therapeutic option for AA patients.

Keywords

Aplastic anemia Androgens Danazol HSCT 

Notes

Conflict of interest

The authors declare that there are no conflicts of interest in the present manuscript.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • José Carlos Jaime-Pérez
    • 1
    • 2
    Email author
  • Perla R. Colunga-Pedraza
    • 1
  • Cynthia D. Gómez-Ramírez
    • 1
  • César H. Gutiérrez-Aguirre
    • 1
  • Olga G. Cantú-Rodríguez
    • 1
  • Luz C. Tarín-Arzaga
    • 1
  • David Gómez-Almaguer
    • 1
  1. 1.Department of Hematology, Internal Medicine Division“Dr. José Eleuterio González” University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo LeónMonterreyMexico
  2. 2.Servicio de Hematología, Edificio “Dr. Rodrigo Barragán”, 2° pisoHospital Universitario “Dr. José E. González”MonterreyMexico

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