PMID- 10986151
OWN - NLM
STAT- MEDLINE
DCOM- 20001030
LR  - 20051116
IS  - 0268-960X (Print)
IS  - 0268-960X (Linking)
VI  - 14
IP  - 3
DP  - 2000 Sep
TI  - Aplastic anaemia: management.
PG  - 157-71
AB  - Acquired, idiosyncratic aplastic anaemia (AA) is a rare but potentially fatal 
      haematological disorder. Severe AA constitutes an acute medical emergency, and 
      supportive therapy is needed to prevent overwhelming sepsis or a life threatening 
      haemorrhage. Specific therapy for the disease includes the choice between 
      allogeneic stem cell transplantation (SCT) from an HLA-identical sibling or 
      immunosuppressive therapy with anti-thymocyte globulin (ATG) and cyclosporin A 
      (CSA). Long-term cure rates of 75-90% are now achieved following HLA (human 
      leukocyte antigen) identical sibling bone marrow transplant. The use of donors 
      other than HLA-id siblings for transplantation in AA remains experimental. 
      Transplantation offers the patient a chance of cure, whilst treatment with 
      immunosuppressive therapy carries a long-term risk of relapse and clonal 
      transformation. The haemopoietic growth factors, apart from granulocyte colony 
      stimulating factor (G-CSF), have been shown to be potentially toxic when given to 
      patients with AA. A short course of G-CSF may be useful to help treat severe 
      infection, but its longer-term use with ATG and CSA remains controversial. 
      Results from immunosuppressive treatment continue to improve with time, as a 
      result of the additional use of CSA with ATG, the use of repeat courses of ATG 
      for non-responders and improvements in the supportive care of patients.
CI  - Copyright 2000 Harcourt Publishers Ltd.
FAU - Killick, S B
AU  - Killick SB
AD  - Department of Haematology, St George's Hospital Medical School, Cranmer Terrace, 
      London, SW17 ORE, UK.
FAU - Marsh, J C
AU  - Marsh JC
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Blood Rev
JT  - Blood reviews
JID - 8708558
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantigens)
SB  - IM
MH  - Anemia, Aplastic/*therapy
MH  - Hematopoietic Stem Cell Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantigens
MH  - Transplantation, Homologous
RF  - 116
EDAT- 2000/09/15 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/09/15 11:00
PHST- 2000/09/15 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/09/15 11:00 [entrez]
AID - S0268-960X(00)90133-4 [pii]
AID - 10.1054/blre.2000.0133 [doi]
PST - ppublish
SO  - Blood Rev. 2000 Sep;14(3):157-71. doi: 10.1054/blre.2000.0133.