Summary
The management of aplastic anemia continues to challenge clinical investigators. With bone marrow transplantation or immunosuppression the prognosis of the patient with aplastic anemia has improved remarkably. For patients who are not eligible for bone marrow transplantation, antilymphocyte globulin has become the standard treatment. There is growing evidence that some patients also respond to immunosuppression with cyclosporin A. Further data suggest that combination of cyclosporin A with antilymphocyte globulin or androgens might be beneficial. An international workshop summarized the data on cyclosporin A treatment in aplastic anemia and attempted to create guidelines for the use of cyclosporin A in the management of aplastic anemia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bacigalupo A, Hows J, Van Lint MT, Chapel M, McCann S, den Ottolander GJ, Gluckman E, Hinterberger W, Ljungman P, Marin P, Nissen C, Raghavachar A (1991) Treatment of severe aplastic anemia (SAA) with antilymphocyte globulin (ALG) plus methylprednisolone (MPred) with or without androgens: a randomized trial from the EBMT SAA Working Party (Abstract). Exp Hematol 19: 526
Barbano GC, Schenone A, Roncella S, Ghio R, Corcione A, Mori PG, Ferrarini M, Pistoia V (1988) Anti-lymphocyte globulin stimulates normal human T cells to proliferate and to release lymphokines in vitro: a study at the clonal level. Blood 72: 956
Bridges R, Pineo GF, Blahey WB (1987) Cyclosporin A (CSA) for the treatment of aplastic anemia refractory to antithymocyte globulin. Am J Hematol 26: 83–87
Esperou H, Devergie A, Lehn P, Lallemand A, Gluckman E (1989) A randomized study comparing cyclosporin A and anti-thymocyte globulin for treatment of severe aplastic anemia. Nouv Rev Fr Hematol 31: 65–68
Frickhofen N, Heit W, Raghavachar A, Porzsolt F, Heimpel H (1986) Treatment of aplastic anemia with cyclosporin A, methylprednisolone, and antithymocyte globulin. Klin Wochenschr 64: 1165–1170
Frickhofen N, Kaltwasser JP, Schrezenmeier H, Raghavachar A, Vogt HG, Herrmann F, Freund M, Meusers P, Salama A, Heimpel H (1991) Treatment of aplastic anemia with anti-lymphocyte globulin and methylprednisolone with or without cyclosporine. N Engl J Med 324: 1297–1304
Graffenried B von, Friend D, Shand N, Scheiss W, Timonen P (1989) Cyclosporin A (Sandimmun) in autoimmune disorders. In: Thomson AW (ed) Sandimmun: mode of action and clinical application. Kluwer Academic, Dordrecht, pp 213–251
Hinterberger-Fischer M, Höcker P, Lechner K, Seewann H, Hinterberger W (1989) Oral cyclosporin-A is effective treatment for untreated and also for previously immunosuppressed patients with severe bone marrow failure. Eur J Haematol 43: 136–142
Jacobs P, Wood L, Martell RW (1985) Cyclosporin A in the traetment of severe acute aplastic anemia. Br J Haematol 61: 267–272
Kahan BD (1989) Cyclosporine. N Engl J Med: 1726–1738
Kawano Y, Nissen C, Gratwohl A, Speck B (1988) Immunostimulatory effects of different antilymphocyte globulin preparations: a possible clue to their clinical effect: Br J Haematol 68: 115
Leonard EM, Raefsky E, Griffith P, Kimball J, Nienhuis AW, Young NS (1989) Cyclosporine therapy of aplastic anaemia, congenital and acquired red cell aplasia. Br J Haematol 72: 278–284
Seip M, Vidnes J (1985) Cyclosporine A in a case of refractory severe aplastic anemia. Scand J Haematol 34: 228–230
Stryckmans P, Dumont JP, Velu T, Debusscher L (1984) Cyclosporine in refractory severe aplastic anemia (Letter). N Engl J Med 310: 655–656
Taniguchi Y, Frickhofen N, Raghavachar A, Digel W, Heimpel H (1990) Antilymphocyte immunoglobulins stimulate peripheral blood lymphocytes to proliferate and release lymphokines. Eur J Haematol 44: 244–251
Torok-Storb B (1990) Etiological mechanisms in immune-mediated aplastic anemia. Am J Pediatr Hematol Oncol 12: 396–401
Wisloff F, Godal HC (1985) Cyclosporine in refractory aplastic anemia. N Engl J Med 312: 1193
Author information
Authors and Affiliations
Additional information
Summary of an “International expert workshop — cyclosporin in aplastic anemia” held on September 4, 1991, at Kongreßzentrum, Basel, on occasion of the XI meeting of the International Society of Haematology. The workshop was sponsored by Sandoz Ltd., Nuremberg, Federal Republic of Germany
Rights and permissions
About this article
Cite this article
Schrezenmeier, H., Schlander, M. & Raghavachar, A. Cyclosporin A in aplastic anemia — report of a workshop. Ann Hematol 65, 33–36 (1992). https://doi.org/10.1007/BF01715123
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01715123