New therapies for aplastic anemia

Cyclosporine A in five children with severe aplastic anemia

Five children with aplastic anemia (AA) were treated with Cyclosporine A (CyA) after failure or poor response to other immunosuppressive agents. A complete remission was achieved in 3 patients, a good partial response in 1, and a poor partial response in another. In 1 patient in whom a complete remission was obtained, a relapse occurred 4 months after CyA was stopped. The treatment was resumed and a complete remission was again observed. Four patients were still on treatment, and side effects were mild. CyA appeared to be an effective treatment in AA.

Cyclosporin A in the treatment of severe aplastic anemia: description of a case complicated by the development of tubercular pericarditis during treatment

We report on a 62 year-old woman who developed a severe aplastic anemia requiring frequent packed red cell and platelet transfusions. Since conventional pharmacological therapy was ineffective, treatment with Cyclosporin A was started, resulting in a significant increase of leukocyte, platelet, and red cell counts. However, 5 months after the beginning of Cyclosporin A treatment, despite a past medical history not significant for clinical tuberculosis, the patient developed tubercular pericarditis. This report underlines the need for a careful follow-up of Cyclosporin A-treated patients aimed at a prompt diagnosis of possible infectious complications.

Invasive aspergillosis in a patient with aplastic anemia receiving amphotericin B

Invasive mycotic infections are becoming more commonplace in immune-compromised hosts. Aspergillus species is the most commonly encountered fungal genus in our environment causing paranasal sinus fungal infection. Aspergillus paranasal sinus infections in the healthy host are readily treated and controlled. In the immune-compromised host this common organism can rapidly become fatal even if recognized and treated appropriately. We present a case history of a patient who died from her disease despite radical surgery and antifungicidal therapy. Recent methods for early diagnosis will be reviewed. Only one other case has been reported in the literature of a patient developing fulminant aspergillosis sinusitis while receiving amphotericin B.