Sustained trilineage response in a patient with ALG-resistant severe aplastic anaemia after treatment with G-CSF, erythropoietin and cyclosporin A: association of recovery with marked elevation of serum alkaline phosphatase

Br J Haematol. 1993 Nov;85(3):608-10. doi: 10.1111/j.1365-2141.1993.tb03355.x.

Abstract

Aplastic anaemia is characterized by multilineage bone marrow failure resulting in pancytopenia. We have successfully treated a young woman with severe aplastic anaemia (SAA) who was resistant to antilymphocyte globulin (ALG) and corticosteroids, with a combination therapy consisting of erythropoietin, cyclosporin A and granulocyte-colony stimulating factor (G-CSF). The patient received erythropoietin and CSA for a period of 10 months without success before G-CSF treatment was started. After 6 weeks of G-CSF therapy she responded with a sustained trilineage recovery. This suggests that immunosuppression together with haemopoietic growth factors may be an effective treatment in patients with SAA who are ALG resistant and cannot be treated by BMT.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Alkaline Phosphatase / blood*
  • Anemia, Aplastic / blood
  • Anemia, Aplastic / enzymology
  • Anemia, Aplastic / therapy*
  • Antilymphocyte Serum / therapeutic use
  • Cyclosporine / therapeutic use*
  • Drug Resistance
  • Drug Therapy, Combination
  • Erythropoietin / therapeutic use*
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Prednisolone / therapeutic use

Substances

  • Antilymphocyte Serum
  • Erythropoietin
  • Granulocyte Colony-Stimulating Factor
  • Cyclosporine
  • Prednisolone
  • Alkaline Phosphatase