Immunsuppressive Therapie der Panmyelopathie: Erfahrungen mit unterschiedlichen Therapieformen bei 42 Patienten

Immunosuppressive treatment according to four different regimens was administered over the course of eight years to 42 patients with aplastic anemia. With treatment protocols which included horse-ALG and horse-ATG, remissions were achieved in most patients, while with rabbit-ATG improvement was obtained, but only minimally, in 15 patients. First results with Cyclosporin A confirmed the effectiveness of this immunosuppressive agent in the treatment of aplastic anemia. The development of remission was, independently of treatment schedule, recognizable 23-88 days after onset of treatment. Often only partial remission was achieved. The long-term course, especially also survival, correlated with the results achieved within the first three months after onset of treatment. Recurrences occurred in 19% of patients but responded to repeated immunosuppressive treatment if preceded by complete remission. Side-effects to ALG and ATG occurred only during the first two weeks and were easily controllable. In some cases Cyclosporin A led to subjectively distressing side-effects.