Immunosuppressive therapy of cyclosporin A for severe benzene-induced haematopoietic disorders and a 6-month follow-up.
Long-term exposure to benzene can potentially result in severe haematotoxicities, including pancytopaenia, aplastic anaemia and myelodysplastic syndrome, which are often accompanied by life-threatening symptoms and high mortality. Previous studies demonstrate that benzene-induced haematotoxicities are immune-mediated and that cyclosporin A is a prominent treatment in acquired aplastic anaemia. This study aims to evaluate the potential role of cyclosporin A immunosuppressive therapy for severe benzene-induced haematotoxicity. Between January 2002 and December 2008, 41 patients with severe benzene-induced haematopoietic disorders from five hospitals were enrolled in the study, 22 patients received cyclosporin A, supportive treatments and/or oral testosterone undecanoate, 19 patients were treated with supportive treatments and/or oral testosterone undecanoate as the control group, and a 6-month follow-up was conducted. The results showed that in the cyclosporin A group, 19 of 22 patients (86.36%) had responded to the treatments completely or partially with increased platelets, white blood cells and hemoglobulin counts by the fourth week (P=0.005), the sixth week (P=0.001) and the third month post-treatment (P=0.034), respectively. However, in the control group treated by supportive methods, only 5 of 19 patients (26.32%) responded to the treatments partially (P<0.001). Cyclosporin A in conjunction with supportive treatments may be an effective treatment modality for patients with severe benzene-induced haematopoietic disorders, which in turn implies that these haematotoxicities are immune-mediated.
Song
Yuguo
Y
Department of Occupational Medicine and Clinical Toxicology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, No. 8 Baijiazhuang Road, Beijing, China. songrain123@hotmail.com
Du
Xuqin
X
Hao
Fentong
F
Gu
Xiaoxin
X
Zhang
Zhenghua
Z
Zhang
Songquan
S
Li
Chunsheng
C
Li
Huiling
H
Ma
Jing
J
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000139:chemically induced / Q000188:drug therapy; D001554:Benzene / Q000009:adverse effects*; D001855:Bone Marrow Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D016572:Cyclosporine / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D009190:Myelodysplastic Syndromes / Q000139:chemically induced / Q000188:drug therapy; D016273:Occupational Exposure / Q000009:adverse effects; D013739:Testosterone / Q000031:analogs & derivatives / Q000627:therapeutic use; D055815:Young Adult
D007166:Immunosuppressive Agents; D013739:Testosterone; D016572:Cyclosporine; C010792:testosterone undecanoate; D001554:Benzene