Rauf Niazi, Nighat Bilal, Noor Khan, Haroon Khan.
Comparison of cyclosporin vs. high dose corticosteroids in the management of Aplastic Anemia.
J Pak Inst Med Sci Jan ;8-12:588-91.

Pancytopenia and Hypocellular bone marrow define the disease, aplastic anaemia, which if severe, leads to a survival rate of only 20%, after the first six months. Bone Marrow Transplantation (BMT), can cure the majority of transplanted patients of severe aplastic anaemia. In the absence of BMT facility, immunosuppressant therapy can be utilised as an alternative. Cyclosporin is an easily available and cheaper modality of treatment. To compare the safety and efficacy of cyclosporin, as compared to high dose corticosteroids, in the treatment of severe aplastic anaemia SAA, 32 patients were enrolled over a period of two and a half years. They were placed in random manner in to two equal groups. The study groups were assessed, 3 months each, for response and side effect profile. 7 out of 16 patients in cyclosporin group (43%), demonstrated a partial response, as compared to only 2 (8%) patients in the high dose corticosteroid group. Side effects were minimal in the cyclosporin group and easily monitored. Although the relapse rate was high (71 %), two months after disccontinuation of therapy, majority responded to reinstitution of the treatment modality. Cyclosporin, in our population, provides an easily available, comparatively cheaper, relatively safe, readily monitored, modality of treatment, in patients with severe aplastic anaemia.

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