Abstract
In the past 25 years a variety of therapies have been introduced for the treatment of aplastic anemia. The most encouraging results have been the complete hematological recovery associated with bone marrow transplantation from sibling donors to patients less than 25 years of age.1 In older patients the results with bone marrow transplantation have been less desirable because of the complications of graft-versus-host (GVH) disease and infection. In this older age group, immune suppression therapy with glucocorticoids or antithymus globulin (ATG) has been used with variable enthusiasm in the past decade. From the Cooperative Group report in Europe, ATG or methylprednisolone therapy appears to have had similar response rates, and the side effects from these immune suppressive drugs have been tolerable.2,3 The recovery rate of aplastic anemia with different preparations of ATG has varied.4 However, in the United States the sustained clinical responses have ranged about 40%, but most clinical series have used one ATG preparation (Atgam, UpJohn).5
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Camitta B, Storb R, Thomas E. Aplastic anemia, pathogenesis, diagnosis, treatment and prognosis. N Engl J Med 1982; 306:645–652.
Gluckman E, Marmont A, Speck B, Gordon-Smith E. Immunosuppressive treatment of aplastic anemia as an alternative treatment for bone marrow transplantation. Sem Hematol 1984; 21:11–19.
Speck B, Gratwohl A, Nissen C et al. Treatment of severe aplastic anemia. Exp Hematol 1986; 14:126–132.
O’Reilly RJ, Camitta B, Nathan DG. Antithoracic duct lymphocyte globulin (letter). 1983; Blood 62:1304.
Young N. A Multicenter trial of antilymphocyte globulins (Upjohn ATG) in bone marrow failure. In: Marmont AM, Bacigalupo A, Van Lint MT, eds. Bone Marrow Transplantation Suppl. 1. London, Macmillan, 1986: pp. 24–25.
Besa EC, Dale DC, Wolff SM, Gardner FH. Aetiocholanolone and prednisolone therapy in patients with severe bone marrow failure. Lancet 1977; 1:728–730.
Camitta BM, Thomas ED, Nathan DG et al. A prospective study of androgens and bone marrow transplantation for treatment of severe aplastic anemia. Blood 1979; 53:504–514.
Wolff SM, Kimball HR, Marshall JR. The effects of hydrocortisone and estrogen on experimental fever induced by etiocholanolone. J Infect Dis 1973; 128:243–247.
Miller WJ, Branda RF, Flynn PJ et al. Antithymocyte globulin treatment of severe aplastic anemia. Br J Haematol 1983; 55:17–25.
Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53:457–481.
Dixon WJ ed. Biomedical Computer Program P Series. Berkeley, University of California Press, 1982.
Bessman JD, Gardner FH. Persistence of abnormal red cell and platelet phenotype during recovery from aplastic anemia. Arch Intern Med 1985; 145:293–297.
Kalwasser JP, Dix V, Schalk KP, et al. Effects of androgens on the response to antithymocyte globulin in patients with aplastic anemia. Eur J Haematol 1988; 40:111–118.
Gardner FH, Juneja HS. Androstane therapy to treat aplastic anaemia in adults: An uncontrolled pilot study. Br J Haematol 1987; 65:295–300.
Gardner FH, Besa EC. The effects of steroid and metabolites on bone marrow function. Chapter 23 In: Najean Y, ed., Medullary Aplasia. Masson, New York 1980: pp. 197–203.
Singer J, Adamson J. Steroids and hematopoiesis. III. The response of granulocytic and erythroid colony-forming cells to steroids of different classes. Blood 1976; 48:855–864.
Najean Y, Chedeville A, Eberlin A, et al. A study of the efficacy of 5a and 5β-androstanes in chronic experimental aplastic anemia in mice. Nouv Rev Fr Hematol 1984; 26:391–396.
Kappas A, Hellman L, Fukushima DK, Gallagher TF. The thermogenic effects and metabolic fate of etiocholanolone in man. J Clin Endocrinol Metab 1985; 18:1043–1055.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1990 Springer-Verlag Inc.
About this chapter
Cite this chapter
Gardner, F.H., Juneja, H.S. (1990). The Use of Etiocholanolone and Antithymus Globulin to Treat Aplastic Anemia: An Uncontrolled Comparative Study. In: Shahidi, N.T. (eds) Aplastic Anemia and Other Bone Marrow Failure Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3254-4_13
Download citation
DOI: https://doi.org/10.1007/978-1-4612-3254-4_13
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-7935-8
Online ISBN: 978-1-4612-3254-4
eBook Packages: Springer Book Archive