RESUMO
Low course doses of cyclophosphamide (1.9 +/- 0.2 g) were given to postsplenectomy patients with grave aplastic anemia (GAA). A total of 27 patients aged 14-42 years were treated, 27 control GAA patients did not receive cyclophosphamide. The cyclophosphamide therapy was controlled by T-lymphocyte functional activity assessed in active rosette formation test with levamisole in vitro. 19 (70.3%) patients were treated twice. The remission was achieved in 22 patients (81.5%), partial response was in 1 patient (3.7%), 4 patients died (14.8%). In control subjects the remission was recorded only in 4 subjects, 23 patients died 3 to 12 months after splenectomy. It is evident that low-dose courses of cyclophosphamide are highly effective in case of control over immunological activity of the pathological process.
Assuntos
Anemia Aplástica/tratamento farmacológico , Ciclofosfamida/administração & dosagem , Imunossupressores/administração & dosagem , Adolescente , Adulto , Anemia Aplástica/sangue , Anemia Aplástica/mortalidade , Terapia Combinada , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Cuidados Pós-Operatórios , Indução de Remissão , Esplenectomia , Fatores de TempoRESUMO
Efficacy of splenectomy at initial stage of multimodality treatment of severe aplastic anemia was assessed in 25 patients aged 15-42. None of the patients achieved remission though there was a relief of hemorrhagic syndrome, diminished requirement in transfusion of donor platelets, a persistent rise in the counts of reticulocytes, leukocytes, absolute number of granulocytes in peripheral blood on postoperative days 14-21 and 60. All the patients were subsequently treated with immunodepressants.