Acquired aplastic anemia an experience with different drug therapies. | [Pakistan Paediatric Journal • 2003]

Author(s):

1. Shabbir Agha Ali: Department of Paediatric Medicine, The Children Hospital & the Institute of Child Health, Lahore, Pakistan

2. Muhammad Haroon Hamid: Department of Pathology, The Children’s Hospital & the Institute of Child Health, Lahore, Pakistan

3. Mohammad Ali Khan: Department of Pathology, The Children’s Hospital & the Institute of Child Health, Lahore, Pakistan

4. Farhana: Department of Pathology, The Children’s Hospital & the Institute of Child Health, Lahore, Pakistan

5. Nisar Ahmad: Department of Pathology, The Children’s Hospital & the Institute of Child Health, Lahore, Pakistan

Abstract:

Aplastic anemia is a significant health problem in pediatric population. Bone marrow transplant is the treatment of choice, but due to lack of facilities immunosuppressive drugs. have been tried with variable results. This study was carried out to access the outcome of acquired aplastic anemia when treated with different immunosuppressive drugs. Children admitted to the Hematology/ Oncology department of the Children’s Hospital, Lahore with the diagnosis of aplastic anemia were enrolled and divided into three treatment groups: group-A= IV methylprednisolone, group-B = oral cyclosporin-A with steroids and group-C= antithymocyte globulins (ATG). Response to therapy was assessed by six months follow up, clinically and by periodic estimation of Hb, TLC, absolute neutrophil count (ANC), Platelet counts and the transfusion requirements. Of 35 patients diagnosed as acquired aplastic anemia, 20 were followed for six months after completion of therapy. Nine patients were male and eleven female with age range of 19 months to 14 years. Majority (70%) presented with combination of pallor and bleeding/ bruising. Eight patients received methylprednisolone, 8 were given cyclosporin and four were treated with ATG. Overall survival rate was 75% during study period. Statistically significant improvement in hematological variables was seen only in cyclosporin group. In group A hematological values declined within first month of post-therapy observation period. In group B decline started after 3rd month. Half (2/4) of the patients in group C maintained their values and remained transfusion free during the study period. Isolated use of steroids has no significant role in acquired aplastic anemia. Cyclosporin A may be beneficial when used in higher doses, in combination with steroids and for longer duration. More studies with larger sample size and longer duration of follow up are required to establish the role of ATG.

Page(s): 19-27

DOI: DOI not available

Published: Journal: Pakistan Paediatric Journal, Volume: 27, Issue: 1, Year: 2003

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