Danazol as first-line therapy for aplastic anemia.

Autor: Jaime-Pérez, José Carlos, Colunga-Pedraza, Perla R., Gómez-Ramírez, Cynthia D., Gutiérrez-Aguirre, César H, Cantú-Rodríguez, Olga G., Tarín-Arzaga, Luz C., Gómez-Almaguer, David
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Zdroj: Annals of Hematology; May2011, Vol. 90 Issue 5, p523-527, 5p, 1 Chart, 1 Graph
Abstrakt: Immunosuppressive therapy (IST) with anti-thymocyte globulin (ATG) plus cyclosporine A (CsA) is the standard treatment for aplastic anemia (AA) patients not eligible for allogeneic hematopoietic stem cell transplantation (HSCT). In the absence of ATG + CsA, androgens continue to be a treatment option. We documented the clinical evolution of AA patients treated with danazol instead of ATG + CsA. AA patients lacking both, human leukocyte antigen-matched donor and access to IST, were treated with danazol and modern support therapy and compared with those receiving a HSCT. Overall survival (OS), response rates, and death risk odds were calculated. Fifty AA patients were studied. Thirteen received a HSCT and 37 danazol and support therapy. Median daily dose of danazol was 400 mg (300 to 600 mg), administered during a median of 12 months. Five-year OS was higher for patients receiving HSCT (92%) compared to the danazol group (41%) ( P = 0.001). Overall response rate was 46% (17/37) in the danazol-treated group and the median time to initial response was 3 months (1-27). Tendency to achieve remission was similar among severity groups ( P = 0.094). The only adverse side effect recorded on the danazol group was an episode of gastrointestinal bleeding. No patient treated with danazol suffered clonal evolution of his/her disease. Although ATG plus CsA is the therapy of choice for AA patients without a donor when neither HSCT nor IST is available, danazol remains an acceptable therapeutic option for AA patients. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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