[Evaluation of a prospective therapeutic protocol in adult patients with nonsevere aplastic anemia in South Tunisia].
BACKGROUND
Immunosuppressive drugs are usually used in the treatment of acquired aplastic anemia (AAA). The aim of this study was to evaluate the efficiency of a prospective therapeutic protocol using cyclosporine and androgens in the treatment of adult patients with nonsevere AAA.


METHODS
Twenty-nine patients diagnosed and treated at the University Hospital of Sfax (Tunisia), during a 10-year period (1991-2000) were included. In addition to symptomatic treatment (transfusion, antibiotics), all the patients received a specific treatment including two drugs: cyclosporine 5mg/kg per day and androgens 0,5mg/kg per day.


RESULTS
The response rate at three, six and 12 months were 48, 75, and 87%, respectively. Survival rate was 52% at one year, and 37% at five and 10 years. The main toxicities were hepatic, renal, and hypertension, observed in 53, 16 and 15%, respectively. These toxicities were reversible in 65, 87 and 100% of the cases, respectively.


CONCLUSIONS
The response and survival rates in our series are quite satisfactory when compared to those obtained with other immunosuppressive drugs (cyclosporine and antilymphocyte serum) in the literature. The addition of androgens in our patients seemed to potentiate the immunosuppression induced by ciclosporin, but secondary toxic effects were more common.
Bellaaj
H
H
Service d'hématologie, CHU Hédi-Chaker, Sfax 3029, Tunisie.
Kallel
C
C
Elloumi
M
M
Rekik
H
H
Kassar
O
O
Hdiji
S
S
Medhaffar
M
M
Souissi
T
T
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000741:Anemia, Aplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001803:Blood Transfusion; D002985:Clinical Protocols; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000728:Androgens; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine