Use of Cyclosporine A and danazol in treatment of aplastic anemia: A real-world data from a teaching hospital in South India

Girish Kamat, Renukaradhya K. Math, Deepak Goni, Girish Balikai, Ambuja Savanur, Nayana Mudennavar, Palaksha Kanive Javaregowda
In: Asian Journal of Medical Sciences · 2022 · vol. 13(10) , pp. 223–226 · doi:10.3126/ajms.v13i10.45513 · W4298395983
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This retrospective study assessed Cyclosporine A and danazol treatment in 95 aplastic anemia patients, finding an overall 69% response rate among the 26 patients with follow-up.

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This retrospective observational study assessed the utility of cyclosporine A combined with danazol for aplastic anemia in 95 patients treated at a teaching hospital in South India between 2017 and 2020. High attrition was reported, with 69 of 95 patients (73%) lost to follow-up, leaving 26 patients available for outcome assessment; among these, 18 (69%) achieved transfusion independence at 6 months. Of the 18 responders, 2 were very severe, 12 severe, and 4 non-severe cases, with response rates of 61.1% in females and 87.5% in males. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background: Due to financial constraints, there are limited treatment options for Aplastic anemia (AA) in developing countries. Aims and Objectives: In the present observational retrospective study, utility of Cyclosporine A (CsA) along with Danazol (an anabolic steroid) in AA was assessed. Materials and Methods: The study included patients of AA treated in our hospital from 2017 to 2020. Results: The present study included total of 95 patients. Out of these, 69 patients (73%) were lost to follow-up. It was observed that, out of 26 patients who could be followed up, 18 (69%) patients responded to the treatment (transfusion independent) at the end of 6 months. Out of 18 patients who had responded, two were very severe AA, 12 were severe AA, and four were non-severe AA patients. Eleven out of 18 (61.1%) females responded, whereas seven out of eight males (87.5%) responded to the treatment. In four patients who received Eltrombopag in addition to CsA-Danazol, three patients responded to the therapy. Conclusion: Treatment with CsA and Danazol may represent a promising therapy for patients with AA, especially in resource limited settings. Further, large-scale collaborative studies are necessary to evaluate such approaches in management of AA.
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Keywords

Aplastic anemia; Cyclosporine A; Danazol; Retrospective studyAbstract

Background

Due to financial constraints, there are limited treatment options for Aplastic anemia (AA) in developing countries. Aims and Objectives: In the present observational retrospective study, utility of Cyclosporine A (CsA) along with Danazol (an anabolic steroid) in AA was assessed.

Materials and methods

The study included patients of AA treated in our hospital from 2017 to 2020.

Results

The present study included total of 95 patients. Out of these, 69 patients (73%) were lost to follow-up. It was observed that, out of 26 patients who could be followed up, 18 (69%) patients responded to the treatment (transfusion independent) at the end of 6 months. Out of 18 patients who had responded, two were very severe AA, 12 were severe AA, and four were non-severe AA patients. Eleven out of 18 (61.1%) females responded, whereas seven out of eight males (87.5%) responded to the treatment. In four patients who received Eltrombopag in addition to CsA-Danazol, three patients responded to the therapy.

Conclusion

Treatment with CsA and Danazol may represent a promising therapy for patients with AA, especially in resource limited settings. Further, large-scale collaborative studies are necessary to evaluate such approaches in management of AA. Downloads Downloads Published How to Cite Issue Section License Copyright (c) 2022 Asian Journal of Medical Sciences This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Authors who publish with this journal agree to the following terms: - The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work. - Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. - Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

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