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Cyclosporine A treatment in four cases of aplastic anemia

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Summary

Cyclosporine A (CyA) treatment of 4 patients with severe aplastic anemia, who were ineligible for bone marrow transplantation, was carried out for periods of between 12 weeks to 20 months. A normalization of Hb and bone marrow, together with a marked improvement in WBC and platelet counts, were observed in only one of these four patients. The remission was maintained for 20 months under continuous treatment. A relapse occurred only when the patient himself interrupted treatment. No serious side effects were observed with CyA doses of 4–10 mg/kg/daily and blood concentrations of 200–400 ng/ml. No significant changes in T helper/T suppressor ratios were noted during the course of CyA treatment.

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References

  1. Assan R, Debray-Sachs M, Laborie C, Chatenoud L, Feutren G, Quiniou-Debrie MC, Thomas G, Bach JF (1985) Metabolic and immunological effects of cyclosporin in recently diagnosed type 1 diabetes mellitus. Lancet 1: 67–71

    Google Scholar 

  2. Bacigalupo A, Podesta M, Mingari MC, Moretta L, Van Lint MT, Marmont A (1980) Immune suppression of hematopoiesis in aplastic anemia: activity of T gamma lymphocytes. J Immunol 125: 1449–1453

    Google Scholar 

  3. Borel JF, von Graffenfried B (1984) Sandimmun (cyclosporin A) and autoimmunity. Proceedings of the workshop on recent advances in systemic lupus erythematosus (Geneva). Academic Press, London

    Google Scholar 

  4. Camitta BM, Thomas ED, Nathan DG (1979) A prospective study of androgens and bone marrow transplantation for treatment of severe aplastic anemia. Blood 53: 504–514

    Google Scholar 

  5. Champlin R, Ho W, Gale RP (1983) Antithymocyte globulin treatment in patients with aplastic anemia. N Engl J Med 308: 113–118

    Google Scholar 

  6. European Multicenter Trial (1982) Cyclosporin A as a sole immunosuppressive agent in recipients of kidney allografts from cadaver donors. Lancet 2: 57–60

    Google Scholar 

  7. Fairhead SM, Chipping PM, Gordon-Smith EC (1983) Treatment of aplastic anemia with antilymphocyte globulin (ALG). Br J Haematol 55: 7–16

    Google Scholar 

  8. Ferrini S, Moretta A, Biassoni R, Nicolin A, Moretta L (1986) Cyclosporin A inhibits IL-2 production by all human T-cell clones having this function, independent of the T4/T8 phenotype or the coexpression of cytolytic activity. Clin Immunol Immunopathol 38: 79–84

    Google Scholar 

  9. Fidelus RK, Fregusson RM, Widmer MB, Wee SL, Bach FH, Orosz CG (1982) Effect of Cyclosporine A on murine and human T helper cell clones. Transplantation 34: 308–311

    Google Scholar 

  10. Frassoni F, Piaggio G, Bacigalupo A (1983) Effect of Cyclosporin A on CFU-c. Exp Hematol 11 (Suppl 13): 29–31

    Google Scholar 

  11. Gluckman E, Devergie A, Poirier O, Lokiec F (1983) Use of cyclosporine as profylaxis of graft versus-host disease after human allogeneic bone marrow transplantation: report of 38 patients. Transplant Proc 15 (Suppl 12): 2628–2639

    Google Scholar 

  12. Gluckman E, Marmont A, Speck B, Gordon-Smith EC (1984) Immunosuppressive treatment of aplastic anemia as an alternative treatment for bone marrow transplantation. Semin Hematol 21: 11–19

    Google Scholar 

  13. Hoffman R, Zanjani ED, Lutton R, Zalusky R, Wasserman LR (1977) Suppression of erythroid colony formation by lymphocytes from patients with aplastic anaemia. N Engl J Med 296: 10–15

    Google Scholar 

  14. Irschik E, Tilg H, Niederwieser D, Gastl G, Huber Ch, Margreiter R (1984) Cyclosporin blood levels do correlate with clinical complications. Lancet 2: 692–693

    Google Scholar 

  15. Jacobs P, Wood L, Martell RW (1985) Cyclosporin A in the treatment of severe acute aplastic anaemia. Br J Haematol 61: 267–272

    Google Scholar 

  16. Keown PA, Essery-Rice G, Hellstrom A, Sinclair NR, Stiller CR (1985) Inhibition of human in vivo cytotoxic T lymphocyte generation by cyclosporine following organ transplantation. Transplantation 40: 45–49

    Google Scholar 

  17. Krönke M, Leonard WJ, Depper JM, Arya SK, Wong-Staal F, Gallo RC, Waldmann TA, Greene WC (1984) Cyclosporine A inhibits T cell growth factor gene expression at the level of m-RNA transcription. Proc Natl Acad Sci USA 81: 5214–5219

    Google Scholar 

  18. Laskay T, Hansson M, Porwit A, Björkholm M, Berthold W, Kiessling R (1986) Interferon gamma is not the only mediator of suppressed hematopoiesis produced by mononuclear cells from aplastic anemia patients. J Biol Reg Homeostat Agents (in press)

  19. Marder P, Schmidtke JR (1985) Cyclosporin A inhibits helper/inducer surface antigen expression on activated human lymphocytes. Int J Immunopharmacol 7: 165–175

    Google Scholar 

  20. Nakao S, Harada M, Kondo K, Odaka K, Ueda M, Matsue K, Mori T, Hattori K (1984) Effect of activated lymphocytes on the regulation of hematopoieses: suppression of in vitro granulopoiesis by OKT8+Ia+ T cells induced by alloantigen stimulation. J Immunol 132: 160–164

    Google Scholar 

  21. Rodesta M, Bacigalupo A, Frassoni F, Raffo MR, Piaggio G, Repetto M (1983) Generation of CFU-c suppressor T cells in vitro. VI. Effect of cyclosporin A. Acta Haematol (Basel) 70: 163–168

    Google Scholar 

  22. Routhier G, Epstein O, Janossy G, Thomas HC (1980) Effects of cyclosporin A on suppressor and inducer T lymphocytes in primary billiary cirrhosis. Lancet 2: 1223–1226

    Google Scholar 

  23. Seip M, Vidnes J (1985) Cyclosporine A in a case of refractory severe aplastic anemia. Scand J Haematol 34: 228–230

    Google Scholar 

  24. Simons JW, Noga SJ, Colombani PM, Bschorner WE, Coffey DS, Hess AD (1986) Cyclosporine A, an in vitro calmodulin antagonist, induces nuclear lobulations in human T cell lymphocytes and monocytes. J Cell Biol 102: 145–150

    Google Scholar 

  25. Singer J, Brown JE, James MC, Doney K, Warren RP, Storb R, Thomas ED (1978) Effect of peripheral blood lymphocytes from patients with aplastic anemia on granulocytic colony growth from HLA-matched and mismatched marrows: Effect of transfusion sensitization. Blood 53: 104–110

    Google Scholar 

  26. Stiller CR, Dupre J, Gent M (1984) Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset. Science 223: 1362–1364

    Google Scholar 

  27. Stryckmans PA, Dumont JP, Velu Th, Debusscher L (1984) Cyclosporine in refractory severe aplastic anemia. N Engl J Med 310: 655–656

    Google Scholar 

  28. The Canadian Transplant Study Group (1983) A randomized clinical trial of cyclosporine in cadaveric renal transplantation. N Engl J Med 309: 809–816

    Google Scholar 

  29. Torok-Storb B, Sieff C, Storb R, Adamson J, Thomas ED (1980) In vitro test for distinguishing possible immune-mediated aplastic anemia from transfusion-induced sensitization. Blood 55: 211–215

    Google Scholar 

  30. Tötterman TH, Nisell J, Killander A, Gahrton G, Lönnqvist B (1984) Succesful treatment of pure red-cell aplasia with cyclosporin. Lancet 2: 693

    Google Scholar 

  31. Visloff F, Godal HCh (1985) Cyclosporine in refractory severe aplastic anemia. N Engl J Med 312: 1193

    Google Scholar 

  32. Wagner H (1983) Cyclosporin A: mechanism of action. Transplant Proc 15: 523–529

    Google Scholar 

  33. Zoumbos N, Gascon P, Young N (1984) The function of lymphocytes in normal and suppressed hematopoiesis. Blut 48: 1–9

    Google Scholar 

  34. Zoumbos NC, Gascon P, Djeu J, Young (1983) Interferon is a mediator of hematopoietic suppression in aplastic anemia in vitro and possibly in vivo. Proc Natl Acad Sci Usa 82: 188–195

    Google Scholar 

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Karolinska Hospital, S-10401, Stockholm, Sweden

    A. Porwit, P. Panayotides, E. Mansson, E. Ösby, R. Hast & P. Reizenstein

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  1. A. Porwit
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  2. P. Panayotides
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  3. E. Mansson
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  4. E. Ösby
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  5. R. Hast
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  6. P. Reizenstein
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Porwit, A., Panayotides, P., Mansson, E. et al. Cyclosporine A treatment in four cases of aplastic anemia. Blut 54, 73–78 (1987). https://doi.org/10.1007/BF00321033

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  • DOI: https://doi.org/10.1007/BF00321033

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