More than five years survival of aplastic anaemia patients receiving non-transplant treatment

• Published in: Bone marrow transplantation (Basingstoke) Vol. 43; no. S1; p. S271
• Main Authors: Moicean, A, Popp, A.M, Brinza, M, Calugaroiu, C, Puscariu, T
• Format: Journal Article
• Language: English
• Published: Nature Publishing Group 01-03-2009
• Subjects: Aplastic anemia; Cyclosporine; Danazol; Drug therapy; Health aspects; Romania
• ISSN: 0268-3369

According to World Bank data, released in the 2008 report, Romania has an upper-middle-income economy. The health budget is low and most of expansive treatment for hematological diseases are not large available. Nine three patients with aplastic anemia (AA) was taken in charge by our institution between 1986 and 2002. Eighteen of 93 patients survived more than 5 years. We have studied the clinical characteristics and treatment of them. There were 8 female and 10 male, aged between 15 and 54 years, median 25 years. Eleven patients had severe AA and 7 patients had moderate AA. Fifteen out of 18 patients were transfused erythrocytes dependent and 8 out of 18 patients were transfused thrombocytes dependent. First line treatment was in 9 patients with Cyclosporine A (CsA), in 5 patients with danazol and in 3 patients with methyl-testosterone. Eight out of 18 patients had complete remission (3 with CsA, 3 with danazole and 2 with methyl-testosterone). Ten patients had partial response (6 with CsA, 2 with danazole and 2 with methyltestosterone). Average time until response was 231 days, limits 9 to 950 days (~32 months). Two patients relapsed, both after a first response obtained with CsA, at 3 years and at 5 years and 9 months respectively. The second response was obtained in both cases with CsA too. Five out of 18 patients had a second disease: 1 paroxysmal nocturne hemoglobinuria and 4 myelodisplastic syndrome, at median interval of 181 months (limits 5 years 10 months and 24 years 5 months). Overall survival was 166 months (limits 5 years and 27 years 7 months). In conclusion, a long survival, in selected patients with aplastic anemia could be obtained also with nontransplant regimens of therapy.