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Study of Aplastic Anaemia with Cyclosporine in Resource Poor Setting

机译:资源贫乏地区环孢菌素再生障碍性贫血的研究

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Introduction: Aplastic Anaemia (AA) is a syndrome characterized by peripheral pancytopenia with hypo-cellular marrow. Acquired idiopathic AA is the most common variety, probably of an autoimmune aetiology. Bone Marrow Transplantation (BMT) is the treatment of choice but cost is the limiting factor. Antithymocyte Globulin and Cyclosporine-A is an alternative to BMT. Cyclosporine alone has been tried as a single agent in resource poor setting.Aim: The study was conducted with the aim to observe the treatment response in aplastic anaemia to Cycloserine-A.Materials and Methods: Patients who were diagnosed as AA and opted for Cyclosporine with informed consent were included in the study. All the subjects were started on 5mg/kg of Cyclosporine and were followed up for three months to see the treatment response. This study had the approval from IEC.Results: Twenty patients were enrolled in the study. Age of the patients ranged from 10 to 65 years. Maximum number (10/20) of patients was in the 2nd decade. Most of the patients presented with mucosal bleeds and breathlessness on exertion; the predominant sign was pallor. Eleven patients had severe AA, eight had non severe and one had very severe anaemia. Out of 20, three patients were lost to follow-up and one patient discontinued therapy due to renal dysfunction; finally sixteen patients? data was analysed. Out of 16 patients, 9 responded and 7 did not respond. Complete response was observed in three patients, partial response in six patients. Seven patients had drug toxicity in the form of acute renal failure and gum hypertrophy.Conclusion: Cyclosporine seems to be a reasonable therapeutic option with good response rate and minimal side effects.
机译:简介:再生障碍性贫血(AA)是一种以外周血细胞减少症伴低细胞性骨髓为特征的综合征。获得性特发性AA是最常见的品种,可能是自身免疫病因学。骨髓移植(BMT)是首选的治疗方法,但成本是限制因素。抗胸腺细胞球蛋白和环孢菌素A是BMT的替代品。目的:本研究旨在观察再生障碍性贫血对环氯霉素-A的治疗反应。材料与方法:诊断为AA并选择环孢菌素的患者在知情同意的情况下纳入研究。所有受试者均以5mg / kg的环孢菌素开始服用,并随访3个月以观察治疗反应。该研究获得了IEC的批准。结果:20名患者入选了该研究。患者的年龄为10至65岁。最大患者数(10/20)在第二个十年。大多数患者在运动时表现出粘膜出血和呼吸困难。主要症状是苍白。 11名患者患有严重的AA,8名患者患有非严重的贫血,其中1人患有非常严重的贫血。在20名患者中,有3名患者因肾功能不全而失去了随访,其中1名患者因肾功能不全而中断了治疗。终于有十六位病人?数据进行了分析。在16例患者中,有9例有反应,而7例没有反应。在三名患者中观察到完全缓解,在六名患者中观察到部分缓解。 7例患者以急性肾衰竭和牙龈肥大的形式出现了药物毒性。结论:环孢菌素似乎是合理的治疗选择,反应率高且副作用最小。

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