Use of cyclosporin A in allogeneic bone marrow transplantation for severe aplastic anemia.
We report on 18 months of experience with cyclosporin A (Cy A) in allogeneic bone marrow transplantation for severe aplastic anemia (SAA). Twenty-three patients treated with Cy A for postgraft immunosuppression are described and compared with 14 similar patients with SAA in whom methotrexate (MTX) was used. The early results are encouraging with 73% survival in the Cy A group compared with 43% in the MTX group. The improvement is partly attributable to the low incidence of graft failure. Graft-versus-host disease (GVHD) remains a problem with an overall incidence of 70% in Cy A-treated aplastic patients, although mortality has been ony 14%. Toxicity attributable to Cy A has so far been acceptable and nephrotoxicity is usually mild and reversible. However, three aplastic patients have developed clinically significant renal impairment while receiving both Cy A and aminoglycoside antibiotics.
D000293:Adolescent; D000328:Adult; D000617:Aminoglycosides / Q000097:blood / Q000627:therapeutic use; D000741:Anemia, Aplastic / Q000188:drug therapy / Q000628:therapy*; D016026:Bone Marrow Transplantation; D002648:Child; D003524:Cyclosporins / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006087:Graft vs Host Reaction / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use
D000617:Aminoglycosides; D003524:Cyclosporins; D007166:Immunosuppressive Agents; D008775:Methylprednisolone; D008727:Methotrexate