Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis

M. R. Morales-Polanco, E. Sanchez-Valle, S. Guerrero-Rivera, Laura Gutierrez, B. Delgado-Marquez

Research output: Contribution to journalArticle

Abstract

We report the results of 23 patients with aplastic anemia (AA) treated with a program of 14 lymphocytapheresis (LC). Treatments were performed with apheresis machines, models Haemonetics 30-S and Baxter CS3000, using the standard program. This procedure was done because AA in many cases appears as a result of the action of a T cell population that inhibits hematopoiesis. Theoretically, removal of this clonal population would produce hematopoietic recovery. Of the total of 23 patients, 9 were excluded for final evaluation of treatment results because 7 died during or shortly after treatment (0.7-3 months); one patient abandoned treatment after three LC and another died 7 months later because of transformation to acute leukemia. The remaining 14 patients were included in the final evaluation of treatment; seven females and seven males, average age 46.1 years (range 22-69); 13 with severe, acid one with moderate AA; 11 with recently diagnosed, and 3 with chronic AA; 12 without previous treatment and two treated before with antilymphocyte globulin + oxymetholone (OXM) + cyclosporine A (CsA) with transient partial remission (PR). Besides lymphocytapheresis, 13 patients received OXM; 4 of them GM-CSF and one low dose CsA. Four patients had complete remission lasting > 59.5 months (range 42-78); eight PR (average duration of > 38.6 months), and two minimal remission (> 37 and 29 months). Platelet, reticulocyte and granulocyte counts increased on average at 48.7, 73.3 and 91.4 days, respectively. In conclusion, 14 (60.8%) of 23 patients with AA showed an improvement related to LC treatment, with a survival probability of 63% from the fourth month, the latter with an added beneficial effect of the other therapies used. Larger numbers of patients have to be treated with LC to determine its real usefulness, mechanism of action and the best conditions for its use.

Original languageEnglish (US)
Pages (from-to)85-90
Number of pages6
JournalArchives of Medical Research
Volume28
Issue number1
StatePublished - 1997
Externally publishedYes

Fingerprint

Leukapheresis
Aplastic Anemia
Oxymetholone
Therapeutics
Cyclosporine
Reticulocyte Count
Blood Component Removal
Antilymphocyte Serum
Hematopoiesis
Granulocyte-Macrophage Colony-Stimulating Factor
Granulocytes
Population
Leukemia
Blood Platelets
T-Lymphocytes
Acids
Survival

Keywords

  • Immunosuppression in aplastic anemia
  • Lymphocytapheresis in aplastic anemia
  • Severe aplastic anemia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Morales-Polanco, M. R., Sanchez-Valle, E., Guerrero-Rivera, S., Gutierrez, L., & Delgado-Marquez, B. (1997). Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis. Archives of Medical Research, 28(1), 85-90.

Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis. / Morales-Polanco, M. R.; Sanchez-Valle, E.; Guerrero-Rivera, S.; Gutierrez, Laura; Delgado-Marquez, B.

In: Archives of Medical Research, Vol. 28, No. 1, 1997, p. 85-90.

Research output: Contribution to journalArticle

Morales-Polanco, MR, Sanchez-Valle, E, Guerrero-Rivera, S, Gutierrez, L & Delgado-Marquez, B 1997, 'Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis', Archives of Medical Research, vol. 28, no. 1, pp. 85-90.
Morales-Polanco MR, Sanchez-Valle E, Guerrero-Rivera S, Gutierrez L, Delgado-Marquez B. Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis. Archives of Medical Research. 1997;28(1):85-90.
Morales-Polanco, M. R. ; Sanchez-Valle, E. ; Guerrero-Rivera, S. ; Gutierrez, Laura ; Delgado-Marquez, B. / Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis. In: Archives of Medical Research. 1997 ; Vol. 28, No. 1. pp. 85-90.
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abstract = "We report the results of 23 patients with aplastic anemia (AA) treated with a program of 14 lymphocytapheresis (LC). Treatments were performed with apheresis machines, models Haemonetics 30-S and Baxter CS3000, using the standard program. This procedure was done because AA in many cases appears as a result of the action of a T cell population that inhibits hematopoiesis. Theoretically, removal of this clonal population would produce hematopoietic recovery. Of the total of 23 patients, 9 were excluded for final evaluation of treatment results because 7 died during or shortly after treatment (0.7-3 months); one patient abandoned treatment after three LC and another died 7 months later because of transformation to acute leukemia. The remaining 14 patients were included in the final evaluation of treatment; seven females and seven males, average age 46.1 years (range 22-69); 13 with severe, acid one with moderate AA; 11 with recently diagnosed, and 3 with chronic AA; 12 without previous treatment and two treated before with antilymphocyte globulin + oxymetholone (OXM) + cyclosporine A (CsA) with transient partial remission (PR). Besides lymphocytapheresis, 13 patients received OXM; 4 of them GM-CSF and one low dose CsA. Four patients had complete remission lasting > 59.5 months (range 42-78); eight PR (average duration of > 38.6 months), and two minimal remission (> 37 and 29 months). Platelet, reticulocyte and granulocyte counts increased on average at 48.7, 73.3 and 91.4 days, respectively. In conclusion, 14 (60.8{\%}) of 23 patients with AA showed an improvement related to LC treatment, with a survival probability of 63{\%} from the fourth month, the latter with an added beneficial effect of the other therapies used. Larger numbers of patients have to be treated with LC to determine its real usefulness, mechanism of action and the best conditions for its use.",
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