Immunosuppressive Therapy in Aplastic Anemia

Overview

Journal Indian J Pediatr

Specialty Pediatrics

Date 2012 Jan 26

PMID 22274992

Citations 6

Authors

Vineeta Gupta

Akash Kumar

Vijai Tilak

Isha Saini

Baldev Bhatia

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the response to antithymocyte globulin based immunosuppressive therapy (IST) in pediatric patients with idiopathic aplastic anemia.

Methods: Thirty patients (19 boys and 11 girls) with aplastic anemia received antithymocyte globulin and cyclosporine. Twenty-two patients had severe and 8 had very severe aplastic anemia.

Results: Mean age of the patients was 9.19 ± 2.56 y. Three patients died within 1 mo of therapy, two due to sepsis and one due to intracranial hemorrhage. Twenty-seven patients were analyzed for response to therapy. Eight patients (29.7%) responded at 3 mo: 3 complete response (CR) and 5 partial response (PR). Six mo after the therapy, overall response (OR) was seen in 9/27 (33.3%), with one more patient in no response group achieving partial response. At 1 year, patients in CR maintained their status and 1 patient in PR group relapsed. He again achieved partial response with repeat course of ATG. Responders had significantly shorter duration of illness and higher absolute neutrophil count as compared to non responders to IST. None of the patients developed acute leukemia in the follow up.

Conclusions: The treatment of aplastic anemia in pediatric patients is a challenging task. One third of the patients achieved overall response which included both complete and partial response.

Citing Articles

Response to Immunosuppressive Therapy in Aplastic Anemia-A Single Centre, Prospective Study of 158 Patients from a Tertiary Care Centre in India.

Krishnan M, Amalnath D Indian J Hematol Blood Transfus. 2025; 41(1):107-111.

PMID: 39917506 PMC: 11794913. DOI: 10.1007/s12288-024-01794-y.

Indigenous antithymocyte globulin-equine to treat aplastic anaemia in adults: a case series from two centres in northeast India.

Iqbal A, Phukan A, Sharma C Hematol Transfus Cell Ther. 2024; 46(4):415-419.

PMID: 38302378 PMC: 11451364. DOI: 10.1016/j.htct.2023.08.005.

Idiopathic Aplastic anemia: Indian Perspective.

Dolai T, Jain M, Mahapatra M Indian J Hematol Blood Transfus. 2023; 39(3):357-370.

PMID: 37304471 PMC: 10247658. DOI: 10.1007/s12288-022-01592-4.

Response to Horse ATG (Thymogam, Bharat Serums and Vaccine, India) and Cyclosporine in Aplastic Anemia: A Single Centre, Retrospective Study of 60 Patients from Southern India.

Amalnath D Indian J Hematol Blood Transfus. 2020; 36(3):473-476.

PMID: 32647420 PMC: 7326858. DOI: 10.1007/s12288-019-01137-2.

Immunosuppressive therapy for aplastic anemia: a single-center experience from western India.

Shah S, Jain P, Shah K, Patel K, Parikh S, Patel A Ann Hematol. 2018; 98(1):41-46.

PMID: 30173288 PMC: 6334724. DOI: 10.1007/s00277-018-3487-2.

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