Abnormal cytogenetic clones in patients with aplastic anaemia: response to immunosuppressive therapy

• Published in: British journal of haematology Vol. 104; no. 2; pp. 271 - 274
• Main Authors: Geary, C. G., Harrison, C. J., Philpott, N. J., Hows, J. M., Gordon‐Smith, E. C., Marsh, J. C. W.
• Format: Journal Article
• Language: English
• Published: Oxford, U.K. and Cambridge, USA Blackwell Science Ltd 01-02-1999; Blackwell; Blackwell Publishing Ltd
• Subjects: Adult; Aged; Anemia, Aplastic - genetics; Anemia, Aplastic - therapy; antilymphocyte globulin; Antilymphocyte Serum - therapeutic use; antithymocyte globulin; aplastic anaemia; Biological and medical sciences; Chromosome Aberrations; cyclosporin; Cyclosporine - therapeutic use; cytogenetics; Female; Follow-Up Studies; Hematology; Humans; Immunomodulators; Karyotyping; Male; Medical sciences; Middle Aged; Oxymetholone - therapeutic use; Pharmacology. Drug treatments; Human; Prognosis; Treatment efficiency; Aplastic anemia; Hemopathy; Myelodysplastic syndrome; Chemotherapy; Treatment; Immunotherapy; Cytogenetics; Ciclosporin; Immunosuppressive agent; Antithymocyte globulin
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1999.01187.x

We report the response to immunosuppressive therapy with antithymocyte globulin (ATG) and cyclosporin or oxymetholone in 13 cases of aplastic anaemia (AA) with an abnormal cytogenetic clone detected at or sometime after diagnosis. Blood and bone marrow examination showed no distinctive morphological features of myelodysplasia (MDS) at diagnosis. Haematological response occurred promptly in eight cases; the remainder responded after additional immunosuppression with or without oxymetholone. Three patients had a late relapse of AA, treated successfully by allogeneic bone marrow transplantation in one; the others responded to oxymetholone. Transformation to MDS or acute leukaemia was not observed after a median follow‐up of 4.1 years (range 1.2–11.2). In four patients the cytogenetic clone disappeared after treatment.