The efficacy of cysclosporine combined with androgen in 48 cases of acute and chronic aplastic anemia

Objective To investigate the clinical efficacy of immunosuppressive therapy in acute and chronic aplastic anemia(AAA and CAA),and to decide the low-toxicity effective concentration of cyclosporine A(CSA).?Methods For the 48 trial patients(including 5 AAA and 43 CAA ones),the dosage of CSA was 5-8.5 mg·kg~(-1)·d~(-1),while for the control 15 CAA,the dosage was 2 mg·kg~(-1)·d~(-1) only.The 5 AAA patients were also given high-dose metrisone(HD-MP,15-25 mg·kg~(-1)·d~(-1)).All of the patients were given androgen.The serum CSA concentration in the trial patients was determined weekly to maintain it within the range of 200-400 mg/L.The effective dose of CSA was given over 6 months,while androgen was given over 12 months.?Results The clinical efficacy was appreciable within 2 months,and the overall effective rate was 87.5%.The average absolute number of granulocytes and platelets increased 2.1×10~9/L and 36×10~9/L,respectively.The hemoglobin was increased 37 g/L.Most of the trial patients were ridded of blood transfusion,and 3 of the 5 AAA patients got cured.?Conclusion For aplastic anemia,adequate dosage of CSA and long therapeutic course are needed.The therapy is effective and cheap for aplastic anemia and worthy of wider adoption.