title: Haemopoietic growth factors in aplastic anaemia: a cautionary note. European Bone Marrow Transplant Working Party for Severe Aplastic Anaemia.
abstract: We are concerned about the inappropriate use of haemopoietic growth factors in patients with severe aplastic anaemia (SAA). The treatment of choice for this disorder is bone-marrow transplantation from an HLA-identical sibling donor if the patient is younger than 45 years, but it must be done soon after onset before the patient becomes sensitised by multiple red-cell and platelet transfusions. Other patients should receive immunosuppressive therapy with antithymocyte globulin alone or with cyclosporin or oxymetholone. Haemopoietic growth factors may have a role in stimulation of granulopoiesis after immunosuppressive therapy, but there is no evidence that they can correct the underlying stem-cell defect in SAA, and therefore no justification for their use alone in newly diagnosed SAA. Such treatment is harmful because it delays bone-marrow transplantation, or immunosuppressive therapy in older patients and those without suitable donors, thus reducing the chances of a successful outcome.
authors.affiliation: Department of Haematology, St George's Hospital, London, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Marsh
authors.forename: G
authors.initials: G
authors.lastname: Socie
authors.forename: H
authors.initials: H
authors.lastname: Schrezenmeier
authors.forename: A
authors.initials: A
authors.lastname: Tichelli
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: S R
authors.initials: SR
authors.lastname: McCann
authors.forename: A
authors.initials: A
authors.lastname: Raghavachar
authors.forename: P
authors.initials: P
authors.lastname: Marin
authors.forename: J M
authors.initials: JM
authors.lastname: Hows
mesh_terms: D000367:Age Factors; D000741:Anemia, Aplastic / Q000628:therapy*; D016026:Bone Marrow Transplantation; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D013997:Time Factors
chemical_list: D016298:Hematopoietic Cell Growth Factors