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Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Review Article

New Trends in Nontransplant Therapy for Acquired Aplastic Anemia

Author(s): Shaoxue Ding* and Rong Fu*

Volume 28, Issue 21, 2022

Published on: 10 June, 2022

Page: [1730 - 1737] Pages: 8

DOI: 10.2174/1381612828666220418132432

Price: $65

Abstract

Aplastic anemia (AA) is a hematological disease characterized by pancytopenia and hypofunctional bone marrow hematopoiesis. Patients with AA are treated with either immunosuppressive therapy (IST) using anti-thymocyte globulin (ATG) and cyclosporine (CsA) or hematopoietic stem cell transplantation (HSCT), if a matched donor is available. The standard IST regimen for AA patients results in response rates up to 70% and even higher overall survival. However, primary and secondary failures after IST remain frequent, and to date, all attempts aiming to overcome this problem have been unfruitful. The nontransplant therapeutic options for AA have significantly expanded during the last few years. Here, we review the new trends of nontransplant therapy for AA and summarize the current therapeutic effect of AA.

Keywords: Aplastic anemia, nontransplant therapy, hematological disorder, pancytoperia, hemactopoiesis, immuno suppressive therapy.

[1]
Killick SB, Bown N, Cavenagh J, et al. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol 2016; 172(2): 187-207.
[http://dx.doi.org/10.1111/bjh.13853 ] [PMID: 26568159]
[2]
Graup RB. Chinese Medical Association. Chinese expert consensus on the diagnosis and treatment of aplastic anemia. Zhonghua Xue Ye Xue Za Zhi 2017; 38(1): 1-5.
[3]
Camitta BM, Thomas ED, Nathan DG, et al. Severe aplastic anemia: A prospective study of the effect of early marrow transplantation on acute mortality. Blood 1976; 48(1): 63-70.
[http://dx.doi.org/10.1182/blood.V48.1.63.63 ] [PMID: 779871]
[4]
Young NS. Aplastic Anemia. N Engl J Med 2018; 379(17): 1643-56.
[http://dx.doi.org/10.1056/NEJMra1413485 ] [PMID: 30354958]
[5]
Park HS, Park SN, Im K, et al. Telomere length and somatic mutations in correlation with response to immunosuppressive treatment in aplastic anaemia. Br J Haematol 2017; 178(4): 603-15.
[http://dx.doi.org/10.1111/bjh.14691 ] [PMID: 28699658]
[6]
Townsley DM, Dumitriu B, Liu D, et al. Danazol treatment for telomere diseases. N Engl J Med 2016; 374(20): 1922-31.
[http://dx.doi.org/10.1056/NEJMoa1515319 ] [PMID: 27192671]
[7]
Ogawa S. Clonal hematopoiesis in acquired aplastic anemia. Blood 2016; 128(3): 337-47.
[http://dx.doi.org/10.1182/blood-2016-01-636381 ] [PMID: 27121470]
[8]
Risitano AM. Immunosuppressive therapies in the management of immune-mediated marrow failures in adults: Where we stand and where we are going. Br J Haematol 2011; 152(2): 127-40.
[http://dx.doi.org/10.1111/j.1365-2141.2010.08439.x ] [PMID: 21118194]
[9]
Liu L, Ding L, Hao L, et al. Efficacy of porcine antihuman lymphocyte immunoglobulin compared to rabbit antithymocyte immunoglobulin as a first-line treatment against acquired severe aplastic anemia. Ann Hematol 2015; 94(5): 729-37.
[http://dx.doi.org/10.1007/s00277-014-2279-6 ] [PMID: 25604721]
[10]
Wei J, Huang Z, Guo J, et al. Porcine antilymphocyte globulin (p-ALG) plus cyclosporine A (CsA) treatment in acquired severe aplastic anemia: A retrospective multicenter analysis. Ann Hematol 2015; 94(6): 955-62.
[http://dx.doi.org/10.1007/s00277-015-2308-0 ] [PMID: 25666078]
[11]
Chen M, Liu C, Qiao X, Zhou D, Zhuang J, Han B. Comparative study of porcine anti-human lymphocyte immunoglobulin and rabbit anti-human thymocyte immunoglobulin as a first-line treatment of acquired severe aplastic anemia. Leuk Res 2018; 65: 55-60.
[http://dx.doi.org/10.1016/j.leukres.2018.01.001 ] [PMID: 29306655]
[12]
Zhu Y, Yang Y, Yang W, et al. Efficacy and safety of porcine ALG compared to rabbit ATG as first-line treatment for children with acquired aplastic anemia. Eur J Haematol 2020; 104(6): 562-70.
[http://dx.doi.org/10.1111/ejh.13398 ] [PMID: 32065456]
[13]
Atta EH, Dias DS, Marra VL, de Azevedo AM. Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia: A single-center retrospective study. Ann Hematol 2010; 89(9): 851-9.
[http://dx.doi.org/10.1007/s00277-010-0944-y ] [PMID: 20373101]
[14]
Shin SH, Yoon JH, Yahng SA, et al. The efficacy of rabbit antithymocyte globulin with cyclosporine in comparison to horse antithymocyte globulin as a first-line treatment in adult patients with severe aplastic anemia: A single-center retrospective study. Ann Hematol 2013; 92(6): 817-24.
[http://dx.doi.org/10.1007/s00277-013-1674-8 ] [PMID: 23318980]
[15]
Marsh JC, Bacigalupo A, Schrezenmeier H, et al. Prospective study of rabbit antithymocyte globulin and cyclosporine for aplastic anemia from the EBMT severe aplastic anaemia working party. Blood 2012; 119(23): 5391-6.
[http://dx.doi.org/10.1182/blood-2012-02-407684 ] [PMID: 22544699]
[16]
Clé DV, Atta EH, Dias DSP, et al. Rabbit antithymocyte globulin dose does not affect response or survival as first-line therapy for acquired aplastic anemia: A multicenter retrospective study. Ann Hematol 2018; 97(11): 2039-46.
[http://dx.doi.org/10.1007/s00277-018-3416-4 ] [PMID: 29978284]
[17]
Scheinberg P, Nunez O, Weinstein B, et al. Horse versus rabbit antithymocyte globulin in acquired aplastic anemia. N Engl J Med 2011; 365(5): 430-8.
[http://dx.doi.org/10.1056/NEJMoa1103975 ] [PMID: 21812672]
[18]
Hayakawa J, Kanda J, Akahoshi Y, et al. Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia. Int J Hematol 2017; 105(5): 578-86.
[http://dx.doi.org/10.1007/s12185-017-2179-3 ] [PMID: 28078653]
[19]
Yang N, Chen J, Zhang H, et al. Horse versus rabbit antithymocyte globulin in immunosuppressive therapy of treatment-naïve aplastic anemia: A systematic review and meta-analysis. Ann Hematol 2017; 96(12): 2031-43.
[http://dx.doi.org/10.1007/s00277-017-3136-1 ] [PMID: 28965225]
[20]
Atta EH, Lima CBL, Dias DSP, et al. Predictors of early mortality after rabbit antithymocyte globulin as first-line treatment in severe aplastic anemia. Ann Hematol 2017; 96(11): 1907-14.
[http://dx.doi.org/10.1007/s00277-017-3086-7 ] [PMID: 28815305]
[21]
Scheinberg P, Townsley D, Dumitriu B, et al. Horse antithymocyte globulin as salvage therapy after rabbit antithymocyte globulin for severe aplastic anemia. Am J Hematol 2014; 89(5): 467-9.
[http://dx.doi.org/10.1002/ajh.23669 ] [PMID: 24415649]
[22]
Li JP, Peng GX, Ye L, et al. Retreatment with immunosuppression for 23 patients with refractory or relapsed severe aplastic anemia. Zhonghua Xue Ye Xue Za Zhi 2020; 41(8): 661-5.
[PMID: 32942820]
[23]
Li X, Shi J, Ge M, et al. Outcomes of optimized over standard protocol of rabbit antithymocyte globulin for severe aplastic anemia: a single-center experience. PLoS One 2013; 8(3): e56648.
[http://dx.doi.org/10.1371/journal.pone.0056648 ] [PMID: 23554855]
[24]
Song MK, Chung JS, Joo YD, et al. Is the early cyclosporine A level predictive of the outcome of immunosuppressive therapy in severe aplastic anemia? Eur J Haematol 2009; 83(1): 72-8.
[http://dx.doi.org/10.1111/j.1600-0609.2009.01237.x ] [PMID: 19220415]
[25]
Scheinberg P, Rios O, Scheinberg P, Weinstein B, Wu CO, Young NS. Prolonged cyclosporine administration after antithymocyte globulin delays but does not prevent relapse in severe aplastic anemia. Am J Hematol 2014; 89(6): 571-4.
[http://dx.doi.org/10.1002/ajh.23692 ] [PMID: 24971433]
[26]
Guan J, Sun Y, Fu R, et al. A cohort study of immune and hematopoietic functionality changes in severe aplastic anemia patients treated with immunosuppressive therapy. Medicine (Baltimore) 2019; 98(3): e14149.
[http://dx.doi.org/10.1097/MD.0000000000014149 ] [PMID: 30653151]
[27]
Matsuda K, Koya J, Arai S, Nakazaki K, Nakamura F, Kurokawa M. Cyclosporine therapy in patients with transfusion-independent non-severe aplastic anemia: A retrospective analysis. Intern Med 2019; 58(3): 355-60.
[http://dx.doi.org/10.2169/internalmedicine.1372-18 ] [PMID: 30146592]
[28]
Tichelli A, Schrezenmeier H, Socié G, et al. A randomized controlled study in patients with newly diagnosed severe aplastic anemia receiving antithymocyte globulin (ATG), cyclosporine, with or without G-CSF: A study of the SAA Working Party of the European Group for Blood and Marrow Transplantation. Blood 2011; 117(17): 4434-41.
[http://dx.doi.org/10.1182/blood-2010-08-304071 ] [PMID: 21233311]
[29]
Tichelli A, de Latour RP, Passweg J, et al. Long-term outcome of a randomized controlled study in patients with newly diagnosed severe aplastic anemia treated with antithymocyte globulin and cyclosporine, with or without granulocyte colony-stimulating factor: A severe aplastic anemia working party trial from the european group of blood and marrow transplantation. Haematologica 2020; 105(5): 1223-31.
[http://dx.doi.org/10.3324/haematol.2019.222562 ] [PMID: 31582549]
[30]
Marsh JC, Socie G, Schrezenmeier H, et al. Haemopoietic growth factors in aplastic anaemia: A cautionary note. Lancet 1994; 344(8916): 172-3.
[http://dx.doi.org/10.1016/S0140-6736(94)92763-4 ] [PMID: 7912771]
[31]
Deyell RJ, Shereck EB, Milner RA, Schultz KR. Immunosuppressive therapy without hematopoietic growth factor exposure in pediatric acquired aplastic anemia. Pediatr Hematol Oncol 2011; 28(6): 469-78.
[http://dx.doi.org/10.3109/08880018.2011.568043 ] [PMID: 21707222]
[32]
Kadia TM, Borthakur G, Garcia-Manero G, et al. Final results of the phase II study of rabbit anti-thymocyte globulin, ciclosporin, methylprednisone, and granulocyte colony-stimulating factor in patients with aplastic anaemia and myelodysplastic syndrome. Br J Haematol 2012; 157(3): 312-20.
[http://dx.doi.org/10.1111/j.1365-2141.2012.09064.x ] [PMID: 22360602]
[33]
Socie G, Mary JY, Schrezenmeier H, et al. Granulocyte-stimulating factor and severe aplastic anemia: A survey by the European Group for Blood and Marrow Transplantation (EBMT). Blood 2007; 109(7): 2794-6.
[http://dx.doi.org/10.1182/blood-2006-07-034272 ] [PMID: 17110459]
[34]
Ding SX, Chen T, Wang T, Liu CY, Lu WL, Fu R. The risk of clonal evolution of granulocyte colony-stimulating factor for acquired aplastic anemia: A systematic review and meta-analysis. Acta Haematol 2018; 140(3): 141-5.
[http://dx.doi.org/10.1159/000491816 ] [PMID: 30253387]
[35]
Shao Z, Chu Y, Zhang Y, Chen G, Zheng Y. Treatment of severe aplastic anemia with an immunosuppressive agent plus recombinant human granulocyte-macrophage colony-stimulating factor and erythropoietin. Am J Hematol 1998; 59(3): 185-91.
[http://dx.doi.org/10.1002/(SICI)1096-8652(199811)59:3<185:AID-AJH2>3.0.CO;2-3 ] [PMID: 9798655]
[36]
Wang H, Dong Q, Fu R, et al. Recombinant human thrombopoietin treatment promotes hematopoiesis recovery in patients with severe aplastic anemia receiving immunosuppressive therapy. BioMed Res Int 2015; 2015: 597293.
[http://dx.doi.org/10.1155/2015/597293 ] [PMID: 25861635]
[37]
Wang H, Wu Y, Fu R, et al. Granulocyte transfusion combined with granulocyte colony stimulating factor in severe infection patients with severe aplastic anemia: A single center experience from China. PLoS One 2014; 9(2): e88148.
[http://dx.doi.org/10.1371/journal.pone.0088148 ] [PMID: 24505406]
[38]
Quillen K, Wong E, Scheinberg P, et al. Granulocyte transfusions in severe aplastic anemia: An eleven-year experience. Haematologica 2009; 94(12): 1661-8.
[http://dx.doi.org/10.3324/haematol.2009.010231 ] [PMID: 19996117]
[39]
Scheinberg P. Activity of eltrombopag in severe aplastic anemia. Blood Adv 2018; 2(21): 3054-62.
[http://dx.doi.org/10.1182/bloodadvances.2018020248 ] [PMID: 30425070]
[40]
Zhao Z, Sun Q, Sokoll LJ, et al. Eltrombopag mobilizes iron in patients with aplastic anemia. Blood 2018; 131(21): 2399-402.
[http://dx.doi.org/10.1182/blood-2018-01-826784 ] [PMID: 29632023]
[41]
Alvarado LJ, Huntsman HD, Cheng H, et al. Eltrombopag maintains human hematopoietic stem and progenitor cells under inflammatory conditions mediated by IFN-γ. Blood 2019; 133(19): 2043-55.
[http://dx.doi.org/10.1182/blood-2018-11-884486 ] [PMID: 30803992]
[42]
Desmond R, Townsley DM, Dunbar C, Young NS. Eltrombopag in aplastic anemia. Semin Hematol 2015; 52(1): 31-7.
[http://dx.doi.org/10.1053/j.seminhematol.2014.10.002 ] [PMID: 25578417]
[43]
Schrezenmeier H, Körper S, Höchsmann B. Aplastic anemia: current state of diagnosis and treatment. Internist (Berl) 2015; 56(9): 989-99.
[http://dx.doi.org/10.1007/s00108-015-3662-7 ] [PMID: 26216866]
[44]
Withdrawn: Aplastic Anemia: Alternative immunosuppressive treatments and eltrombopag. a report from the 2014 ebmt educational meeting from the severe aplastic anaemia and infectious diseases working parties. Curr Drug Targets 2015.
[PMID: 25619749]
[45]
Fan X, Desmond R, Winkler T, et al. Eltrombopag for patients with moderate aplastic anemia or uni-lineage cytopenias. Blood Adv 2020; 4(8): 1700-10.
[http://dx.doi.org/10.1182/bloodadvances.2020001657 ] [PMID: 32330244]
[46]
Geng W, Kearney S, Nelson S. Upfront eltrombopag monotherapy induces stable hematologic remission in pediatric patients with nonsevere idiopathic aplastic anemia. Pediatr Blood Cancer 2018; 65(10): e27290.
[http://dx.doi.org/10.1002/pbc.27290 ] [PMID: 29932285]
[47]
Filippidou M, Avgerinou G, Tsipou H, et al. Longitudinal evaluation of eltrombopag in paediatric acquired severe aplastic anaemia. Br J Haematol 2020; 190(3): e157-9.
[http://dx.doi.org/10.1111/bjh.16766 ] [PMID: 32529633]
[48]
Groarke EM, Patel BA, Gutierrez-Rodrigues F, et al. Eltrombopag added to immunosuppression for children with treatment-naïve severe aplastic anaemia. Br J Haematol 2021; 192(3): 605-14.
[http://dx.doi.org/10.1111/bjh.17232 ] [PMID: 33410523]
[49]
Ecsedi M, Lengline É, Knol-Bout C, et al. Use of eltrombopag in aplastic anemia in Europe. Ann Hematol 2019; 98(6): 1341-50.
[http://dx.doi.org/10.1007/s00277-019-03652-8 ] [PMID: 30915499]
[50]
Winkler T, Fan X, Cooper J, et al. Treatment optimization and genomic outcomes in refractory severe aplastic anemia treated with eltrombopag. Blood 2019; 133(24): 2575-85.
[http://dx.doi.org/10.1182/blood.2019000478 ] [PMID: 30992268]
[51]
Townsley DM, Scheinberg P, Winkler T, et al. Eltrombopag added to standard immunosuppression for aplastic anemia. N Engl J Med 2017; 376(16): 1540-50.
[http://dx.doi.org/10.1056/NEJMoa1613878 ] [PMID: 28423296]
[52]
Imada K, Obara N, Iida H, et al. Eltrombopag in combination with rabbit anti-thymocyte globulin/cyclosporine a in immunosuppressive therapy-naïve patients with aplastic anemia in Japan. Intern Med 2021; 60(8): 1159-68.
[http://dx.doi.org/10.2169/internalmedicine.6063-20 ] [PMID: 33229810]
[53]
Hwang YY, Gill H, Chan TSY, Leung GMK, Cheung CYM, Kwong YL. Eltrombopag in the management of aplastic anaemia: Real-world experience in a non-trial setting. Hematology 2018; 23(7): 399-404.
[http://dx.doi.org/10.1080/10245332.2017.1422306 ] [PMID: 29303047]
[54]
Olnes MJ, Scheinberg P, Calvo KR, et al. Eltrombopag and improved hematopoiesis in refractory aplastic anemia. N Engl J Med 2012; 367(1): 11-9.
[http://dx.doi.org/10.1056/NEJMoa1200931 ] [PMID: 22762314]
[55]
Hong Y, Li X, Wan B, Li N, Chen Y. Efficacy and safety of eltrombopag for aplastic anemia: A systematic review and Meta-analysis. Clin Drug Investig 2019; 39(2): 141-56.
[http://dx.doi.org/10.1007/s40261-018-0725-2 ] [PMID: 30406906]
[56]
Zhang J, Wu Y, Liu J, et al. A systematic review and meta-analysis of the safety and efficacy of anti-thymocyte globulin combined with eltrombopag in the treatment of severe aplastic anemia. Ann Palliat Med 2021; 10(5): 5549-60.
[http://dx.doi.org/10.21037/apm-21-1049 ] [PMID: 34107711]
[57]
Yang WR, Han B, Chang H, et al. Efficacy and safety of eltrombopag in aplastic anemia: A multi-center survey in China. Zhonghua Xue Ye Xue Za Zhi 2020; 41(11): 890-5.
[PMID: 33333690]
[58]
Hosokawa K, Yamazaki H, Tanabe M, Imi T, Sugimori N, Nakao S. High-dose romiplostim accelerates hematologic recovery in patients with aplastic anemia refractory to eltrombopag. Leukemia 2021; 35(3): 906-9.
[http://dx.doi.org/10.1038/s41375-020-0950-6 ] [PMID: 32616921]
[59]
Jang JH, Tomiyama Y, Miyazaki K, et al. Efficacy and safety of romiplostim in refractory aplastic anaemia: A Phase II/III, multicentre, open-label study. Br J Haematol 2021; 192(1): 190-9.
[http://dx.doi.org/10.1111/bjh.17190 ] [PMID: 33152120]
[60]
Lee JW, Lee SE, Jung CW, et al. Romiplostim in patients with refractory aplastic anaemia previously treated with immunosuppressive therapy: A dose-finding and long-term treatment phase 2 trial. Lancet Haematol 2019; 6(11): e562-72.
[http://dx.doi.org/10.1016/S2352-3026(19)30153-X ] [PMID: 31474546]
[61]
Khurana H, Malhotra P, Sachdeva MU, et al. Danazol increases T regulatory cells in patients with aplastic anemia. Hematology 2018; 23(8): 496-500.
[http://dx.doi.org/10.1080/10245332.2018.1435045 ] [PMID: 29415633]
[62]
Jaime-Pérez JC, Colunga-Pedraza PR, Gómez-Ramírez CD, et al. Danazol as first-line therapy for aplastic anemia. Ann Hematol 2011; 90(5): 523-7.
[http://dx.doi.org/10.1007/s00277-011-1163-x ] [PMID: 21279356]
[63]
Risitano AM, Schrezenmeier H. Alternative immunosuppression in patients failing immunosuppression with ATG who are not transplant candidates: Campath (Alemtuzumab). Bone Marrow Transplant 2013; 48(2): 186-90.
[http://dx.doi.org/10.1038/bmt.2012.245 ] [PMID: 23222381]
[64]
Scheinberg P, Nunez O, Weinstein B, Scheinberg P, Wu CO, Young NS. Activity of alemtuzumab monotherapy in treatment-naive, relapsed, and refractory severe acquired aplastic anemia. Blood 2012; 119(2): 345-54.
[http://dx.doi.org/10.1182/blood-2011-05-352328 ] [PMID: 22067384]
[65]
Risitano AM, Selleri C, Serio B, et al. Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single-lineage marrow failure: A pilot study and a survey from the EBMT WPSAA. Br J Haematol 2010; 148(5): 791-6.
[http://dx.doi.org/10.1111/j.1365-2141.2009.08027.x ] [PMID: 19995389]
[66]
Gómez-Almaguer D, Jaime-Pérez JC, Garza-Rodríguez V, et al. Subcutaneous alemtuzumab plus cyclosporine for the treatment of aplastic anemia. Ann Hematol 2010; 89(3): 299-303.
[http://dx.doi.org/10.1007/s00277-009-0816-5 ] [PMID: 19705116]
[67]
Thota S, Patel BJ, Sadaps M, et al. Therapeutic outcomes using subcutaneous low dose alemtuzumab for acquired bone marrow failure conditions. Br J Haematol 2018; 183(1): 133-6.
[http://dx.doi.org/10.1111/bjh.14907 ] [PMID: 28905372]
[68]
Scheinberg P, Wu CO, Nunez O, et al. Treatment of severe aplastic anemia with a combination of horse antithymocyte globulin and cyclosporine, with or without sirolimus: A prospective randomized study. Haematologica 2009; 94(3): 348-54.
[http://dx.doi.org/10.3324/haematol.13829 ] [PMID: 19181786]
[69]
Feng X, Lin Z, Sun W, et al. Rapamycin is highly effective in murine models of immune-mediated bone marrow failure. Haematologica 2017; 102(10): 1691-703.
[http://dx.doi.org/10.3324/haematol.2017.163675 ] [PMID: 28729300]
[70]
Lin ZH, Liu H, Zhu L, et al. Rapamycin affect the apoptosis of splenic CD4+CD25+ regulatory T cells of mouse severe aplastic anemia model. Zhonghua Xue Ye Xue Za Zhi 2018; 39(3): 196-201.
[PMID: 29562463]
[71]
Höchsmann B, Moicean A, Risitano A, Ljungman P, Schrezenmeier H. Supportive care in severe and very severe aplastic anemia. Bone Marrow Transplant 2013; 48(2): 168-73.
[http://dx.doi.org/10.1038/bmt.2012.220 ] [PMID: 23208312]
[72]
Pawelec K, Salamonowicz M, Panasiuk A, et al. Influence of iron overload on immunosuppressive therapy in children with severe aplastic anemia. Adv Exp Med Biol 2015; 866: 83-9.
[http://dx.doi.org/10.1007/5584_2015_148 ] [PMID: 26022903]
[73]
Ye L, Jing L, Peng G, et al. Effects of pre-immunosupressive therapy iron overload on hematologic response of severe aplastic anemia. Zhonghua Xue Ye Xue Za Zhi 2016; 37(4): 324-8.
[PMID: 27093997]
[74]
Cheong JW, Kim HJ, Lee KH, et al. Deferasirox improves hematologic and hepatic function with effective reduction of serum ferritin and liver iron concentration in transfusional iron overload patients with myelodysplastic syndrome or aplastic anemia. Transfusion 2014; 54(6): 1542-51.
[http://dx.doi.org/10.1111/trf.12507 ] [PMID: 24313463]
[75]
Shi J, Chang H, Zhang L, et al. Efficacy and safety of deferasirox in aplastic anemia patients with iron overload: A single arm, multi-center, prospective study in China. Zhonghua Xue Ye Xue Za Zhi 2016; 37(1): 1-6.
[PMID: 26876245]
[76]
Scheinberg P, Nunez O, Wu C, Young NS. Treatment of severe aplastic anaemia with combined immunosuppression: Anti-thymocyte globulin, ciclosporin and mycophenolate mofetil. Br J Haematol 2006; 133(6): 606-11.
[http://dx.doi.org/10.1111/j.1365-2141.2006.06085.x ] [PMID: 16704434]
[77]
Brodsky RA, Chen AR, Dorr D, et al. High-dose cyclophosphamide for severe aplastic anemia: Long-term follow-up. Blood 2010; 115(11): 2136-41.
[http://dx.doi.org/10.1182/blood-2009-06-225375 ] [PMID: 20018919]
[78]
Brodsky RA, Chen AR, Brodsky I, Jones RJ. High-dose cyclophosphamide as salvage therapy for severe aplastic anemia. Exp Hematol 2004; 32(5): 435-40.
[http://dx.doi.org/10.1016/j.exphem.2004.02.002 ] [PMID: 15145211]
[79]
Du Y, Huang Y, Zhou W, et al. Effective tacrolimus treatment for patients with non-severe aplastic anemia that is refractory/] intolerant to Cyclosporine A: A retrospective study. Drug Des Devel Ther 2020; 14: 5711-9.
[http://dx.doi.org/10.2147/DDDT.S275975 ] [PMID: 33408460]
[80]
Martynova A, Chiu V, Mert M, Hermel D, Weitz IC. Effectiveness and safety of tacrolimus with or without eltrombopag, as a part of immunosuppressive treatment of aplastic anemia in adults: A retrospective case series. Ann Hematol 2021; 100(4): 933-9.
[http://dx.doi.org/10.1007/s00277-021-04401-6 ] [PMID: 33420879]
[81]
Bian Z, Zhou N, Qiao X, Lu S, Song X, Zhou H. Evaluating the efficacy and anti-infective effect of high-dose intravenous immunoglobulin adjuvant therapy for acquired aplastic anemia children. J Pediatr Hematol Oncol 2019; 41(2): 129-32.
[http://dx.doi.org/10.1097/MPH.0000000000001333 ] [PMID: 30339655]
[82]
Maciejewski JP, Sloand EM, Nunez O, Boss C, Young NS. Recombinant humanized anti-IL-2 receptor antibody (daclizumab) produces responses in patients with moderate aplastic anemia. Blood 2003; 102(10): 3584-6.
[http://dx.doi.org/10.1182/blood-2003-04-1032 ] [PMID: 12881307]
[83]
Sloand EM, Olnes MJ, Weinstein B, et al. Long-term follow-up of patients with moderate aplastic anemia and pure red cell aplasia treated with daclizumab. Haematologica 2010; 95(3): 382-7.
[http://dx.doi.org/10.3324/haematol.2009.013557 ] [PMID: 20207845]
[84]
Chen T, Zhang T, Liu C, et al. NK cells suppress CD8+ T cell immunity via NKG2D in severe aplastic anemia. Cell Immunol 2019; 335: 6-14.
[http://dx.doi.org/10.1016/j.cellimm.2018.10.004 ] [PMID: 30471872]
[85]
Liu LL, Liu L, Liu HH, et al. Levamisole suppresses adipogenesis of aplastic anaemia-derived bone marrow mesenchymal stem cells through ZFP36L1-PPARGC1B axis. J Cell Mol Med 2018; 22(9): 4496-506.
[http://dx.doi.org/10.1111/jcmm.13761 ] [PMID: 29993187]
[86]
Zhao Y, Sun X, Yu X, Gao R, Yin L. Saponins from Panax notoginseng leaves improve the symptoms of aplastic anemia and aberrant immunity in mice. Biomed Pharmacother 2018; 102: 959-65.
[http://dx.doi.org/10.1016/j.biopha.2018.03.175 ] [PMID: 29710551]

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