Fludarabine Plus Cyclosporine for Refractory/Relapse Aplastic Anemia.

To evaluated the efficiency of fludarabine plus cyclosporine for refractory/ relapse aplastic anemia (AA).

We treated 7 refractory/ relapse aplastic anemia (AA) patients by fludarabine plus cyclosporine (fludarabine 25 mg/m², day 1-5; cyclosporine 3mg/kg/d) from November 2003 to April 2008. The concentration of cyclosporine was maintained between 200-300ng/ml. The AA patients who was refractory to immunosuppressive therapy was defined as did not get transfusion dependence 6 months after treatment with ATG (anti-thymocyte globulin, ATG) and cyclosporine, who become transfusion dependent again after transfusion dependence were relapse.

In the patient group, 5 were males and 2 was female, with ages ranging from 12 to 45 years (median=22.5 years). 3 patients previously were treated by ATG plus cyclosporine, 3 were only received cyclosporine, and one was treated by Allo-HSCT (Table 1).

The reponse rate was 57.1%(4/7), all were partial remission with count of neutrophil and levels of hemoglobin achieved normal levels while the number of platelet was lower than 100°Á10⁹/L. No serious infection was found.

Fludarabine plus cyclosporine as a new immunosuppressive therapy for refractory/ relapse aplastic anemia patients is an effective regimen, it was worth to explore in clinical research.

No relevant conflicts of interest to declare.