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抗淋巴细胞球蛋白、大剂量甲泼尼龙和达那唑治疗使严重再生障碍性贫血显著改善

[Severe aplastic anemia remarkably improved by a treatment with antilymphocyte globulin, high-dose methylprednisolone and danazol].

作者信息

Miyamura K, Kojima S, Takeyama K, Matsushita T, Minami S, Kodera Y

出版信息

Rinsho Ketsueki. 1989 Jan;30(1):72-7.

PMID:2716202
Abstract

Sixteen-years-old female with severe aplastic anemia received a therapy combined with antilymphocyte globulin (ALG), high-dose methylprednisolone (m-PSL) and danazol. At the hospitalization, hematological examination demonstrated as follows; reticulocyte 21,000/microliters, granulocyte 350/microliters, platelet 10,000/microliters and hypocellular bone marrow. Treatment schedule were 1) m-PSL 1,000 mg (day 1-4), 500 mg (5-8)--then tapered. 2) ALG lg/day (day 4-8) 3) danazol 600 mg/day. During ALG administration, leukocytopenia and thrombocytopenia appeared but thereafter hematological recovery was obtained and the patient was free from supportive care. She developed mild diabetes mellitus and moderate liver dysfunction, nevertheless, both of which were controlled. At 3 months after the beginning of the treatment, hematological examination demonstrated as follows; reticulocyte 236,000/microliters, granulocyte 1,900/microliters, platelet 56,000/microliters and normocellular bone marrow. Although this immunosuppressive therapy was remarkably effective to this patient, immunological relation to the onset of aplastic anemia was not demonstrated in in vitro examination. This combined therapy seems to be effective one for patients with severe aplastic anemia.

摘要

一名16岁的重度再生障碍性贫血女性接受了抗淋巴细胞球蛋白(ALG)、大剂量甲泼尼龙(m-PSL)和达那唑联合治疗。住院时血液学检查结果如下:网织红细胞21,000/微升,粒细胞350/微升,血小板10,000/微升,骨髓细胞减少。治疗方案为:1)m-PSL 1000毫克(第1 - 4天),500毫克(第5 - 8天),然后逐渐减量。2)ALG 1克/天(第4 - 8天)。3)达那唑600毫克/天。在使用ALG期间,出现了白细胞减少和血小板减少,但随后血液学指标恢复,患者无需支持治疗。她出现了轻度糖尿病和中度肝功能障碍,但均得到了控制。治疗开始3个月后,血液学检查结果如下:网织红细胞236,000/微升,粒细胞1,900/微升,血小板56,000/微升,骨髓细胞正常。尽管这种免疫抑制疗法对该患者非常有效,但体外检查未显示与再生障碍性贫血发病的免疫关系。这种联合疗法似乎对重度再生障碍性贫血患者有效。

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