Clujul Medical - Iuliu Haţieganu

Clujul Medical 2006 vol. LXXX - nr. 1
3. FRICKHOFEN N., HEIMPEL H., KALTWASSER J. P.et al: Antithymocyte
globulin with or without cyclosporine A: 11-year follow-up of a randomized trial
comparing treatments of aplastic anemia, Blood, 2003, 101-4, 1236-1242
4. BACIGALUPO A., BRUNO B., SARRACCO P. et al.: Antilymphocyte globulin,
cyclosporine ,prednisolone, and granulocyte colony- stimulating factor for severe
aplastic anemia: an update of GITMO/EBMT study on 100 patients, Blood, 2000,
95-6, 1931-1934
5. DAVIES J. K., GUINAN E.C., : An overview of management of severe idiopathic
aplastic anemia in children, US Special Populations Pediatrics Review, 2006, 53-
56
6. FUHRER M., RAMPF U., BAUMANN I.. et. al.: Immunosuppressive therapy for
aplastic anemia in children: a more severe disease predict better survival, Blood,
2005, 106-6, 2102-2104
7. KOJIMA S., SHIGEYOSHI H., KOSAKA Y. et. al.: Immunosuppressive therapy
using antithymocyte globulin, cyclosporine, and danazol with or without human
granulocyte colony-stimulating factor in children with acquired aplastic anemia,
Blood, 2000, 96-6, 2049-2054
8. YOUNG N. S., CALADO R.T., SCHEINBERG P.: Current concepts in the
pathophysiology and treatment of aplastic anemia, Blood, 2006, 108-9, 2509-2519
9. MEDEIROS C.R., RIBEIRO R.C., BITTENCOURT M. A. et al: Long- term
outcome of 25 children and adolescents with severe aplastic anemia treated with
antithymocyte globulin, Braz J Med Biol Res, 2000, 33-5, 553-558
Neutropenia with acquired aplastic anemia – clinical aspects
and evolution
VODĂ DANIELA, POPA GHEORGHE, MIU NICOLAE
Summary
Aquired aplastic anemia is rare disease characterised by pancytopenia and
hipoplastic bone marrow. This paper proposed to investigate the clinical aspects and
evolution of aquired aplastic anemia.
We report a descriptive study which included 15 children new diagnosed with
aquired aplastic anemia in II Pediatric Clinic Cluj Napoca, between january 1994 – june
2006. Patients’ evaluation included the medical history, clinical exam, the means of
absolute neutrophils count, platelets and reticulocytes at admission, treatments’
protocols applied and evolution.
We detected 4 cases with very severe aplastic anemia, 8 cases with severe
aplastic anemia and 3 cases with moderate aplastic anemia. The interval between
diagnosis to immunosuppressive therapy was 141 days. We used 7 types of treatment
combinations . The usefulness scheme (8 / 15 cases) was antitymocyte globulin with
methylprednisolone with G-CSF with or without danazol and cyclosporine. The relapse
was observed in 26,6 % ; the severe infections were observed in 33,3%. The mortality
rate was 40 % and the overall survival rate was 60 %.
The majority of cases was severe and moderate aplastic anemia with a
prolonged interval between diagnosis and immunosuppressive therapy.
Key words: aplastic anemia, children, immunosuppressive therapy,
granulocyte colony stimulating factor.
115