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Titolo:
Granulocyte colony-stimulating factor-supported combined immunosuppressivetherapy (antilymphocyte globulin, cyclosporine, and methylprednisolone) inpatients with aplastic anemia: tolerability, efficacy, and changes in the progenitor cell compartment
Autore:
Meidlinger, P; Knobl, P; Jager, U; Gisslinger, H; Pabinger, I; Weltermann, A; Lechner, K; Geissler, K;
Indirizzi:
Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, Gen Hosp Vienna, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 en Hosp Vienna, A-1090 Vienna, Austria
Titolo Testata:
ANNALS OF HEMATOLOGY
fascicolo: 7, volume: 78, anno: 1999,
pagine: 299 - 304
SICI:
0939-5555(199907)78:7<299:GCFCI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; SAA WORKING PARTY; ANTITHYMOCYTE GLOBULIN; RANDOMIZED TRIAL; CHEMOTHERAPY; NEUTROPENIA; INTERLEUKIN-3; SUPPRESSION; ANDROGENS;
Keywords:
aplastic anemia; immunosuppressive therapy; rhG-CSF; erythroid/myeloid progenitor cells;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Geissler, K Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, Gen Hosp Vienna, Wahringer Guertel 18-20, A-1090 Vienna, Austria Univ ViennaWahringer Guertel 18-20 Vienna Austria A-1090 ria
Citazione:
P. Meidlinger et al., "Granulocyte colony-stimulating factor-supported combined immunosuppressivetherapy (antilymphocyte globulin, cyclosporine, and methylprednisolone) inpatients with aplastic anemia: tolerability, efficacy, and changes in the progenitor cell compartment", ANN HEMATOL, 78(7), 1999, pp. 299-304

Abstract

Neutropenic infections are the major cause of morbidity and mortality in the treatment of aplastic anemia (AA) with antilymphocyte globulin (ALG), cyclosporin A (CSA), and methylprednisolone (MP). Recent data suggest a beneficial effect of administering G-CSF as an adjunct to immunosuppression. We have treated 11 consecutive patients with AA using a combined immunosuppressive regimen including ALG, CSA, and MP plus G-CSF at a dose of 5 mu g/kg/day until neutropoietic recovery. In addition to measuring routine hematological parameters we have performed serial determinations of reticulocyte counts and in vitro progenitor cell cultures before and after therapy in orderto assess their predictive value for treatment response and to determine the impact of therapy on early hematopoiesis. One patient died on day 34 of neutropenic septicemia. At 1 year, 81% of patients showed response to treatment. The median time to ANC values >0.5 and >1.0 x 10(9)/l were 19 and 35 days, respectively. Reticulocyte counts started to recover after 6 weeks, and transfusion independence was observed on day 52 for red blood cell transfusions and on day 53 for platelet concentrates. All patients with detectable colony formation in peripheral blood achieved a complete hematological remission, as compared with only one of five patients without progenitor cell growth. Although normal ranges were rarely achieved, there was a small but definitive improvement in progenitor cell numbers as compared with baseline values in most patients. Our results confirm the good tolerability and high efficacy of this G-CSF-supported combined immunosuppressive therapy forAA. Detectable colony growth at diagnosis seems to predict a high chance for complete hematological response.

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Documento generato il 18/09/20 alle ore 17:05:49