Clinical Observation of Combination Therapy of Anti-Thymocyte Globulin Cyclosporine A, Hemopoietic Growth Factor and Androgen for 47 Severe Aplastic Anaemia Cases.

For therapy to severe aplastic anaemia (SAA), the effective and survival rate of combination regime using anti-thymocyte globulin (ATG), globulin, cyclosporine A (CsA), hemopoietic growth factor and androgen are similar to those of hemopoietic stem cell transplantation(HSCT). we have treated 236 cases of SAA from Oct. 1995 to Dec. 2005. 47of them took combination therapy mainly with ATG. The range of age was 10 to 56 (median age was 32). Of all the patients, totle effective rate was 84.5%, 41% achieved complete remission and 43.5% got partial remission. With the median follow-up time of 53 months, 41 patients are survival (87.2%),6 died, 3 relapsed, 4 patients stayed the same, 1 coincided with PNH. The combination therapy mainly with ATG began to work after 1 to 11months (median time was 2.5 months). If one can be treated in 6 months after diagnosis, the effective rate can be 95% after 3 months’ management, but if not, it was only 43%. For patients whose bone marrow hemopoietic cell >30% before treatment, the effective rate was 87.5%, but if it<5%, the effective rate was only 15%. No patients was severely affected by allergy or serum disease caused by ATG during treatment. By using infection preventing method of platelet transfusion and supporting treatment, most of the patients went through risk time and showed therapeutic reaction. We believe that the combination therapy mainly with ATG is safe and effective for SAA. It is considerable for SAA patients without HLA matched donors.

Induction of monocyte proliferation and HIV expression by IL-3 does not interfere with anti-viral activity of zidovudine

Myelosuppression is a major symptom in the acquired immunodeficiency syndrome (AIDS). Moreover zidovudine, an anti-retroviral drug used to treat AIDS patients has myelosuppressive side effects. Therefore treatment with IL-3, a multi-lineage hemopoietic growth factor may be beneficial for zidovudine-treated individuals. In this study we examined the effect of IL-3 on human immunodeficiency virus (HIV) expression. The proliferative response to rIL-3 and the effects on the replication of the monocytotropic HIV variant, HTLV-III Ba-L, in the absence or presence of the anti-retroviral drug zidovudine was studied in purified human peripheral blood monocytes. Zidovudine concentrations sufficient for complete inhibition of HIV replication did not affect rIL-3 induced monocyte proliferation. Although rIL-3, like rGM-CSF, was able to augment HIV expression in monocytes, it did not interfere with the anti-retroviral activity of zidovudine. These data indicate that rIL-3 is a potential candidate for use in myelosupportive therapy in AIDS patients treated with anti-retroviral drugs.

Induction of monocyte proliferation and HIV expression by IL-3 does not interfere with anti-viral activity of zidovudine

Myelosuppression is a major symptom in the acquired immunodeficiency syndrome (AIDS). Moreover zidovudine, an anti-retroviral drug used to treat AIDS patients has myelosuppressive side effects. Therefore treatment with IL-3, a multi-lineage hemopoietic growth factor may be beneficial for zidovudine-treated individuals. In this study we examined the effect of IL-3 on human immunodeficiency virus (HIV) expression. The proliferative response to rIL-3 and the effects on the replication of the monocytotropic HIV variant, HTLV-III Ba-L, in the absence or presence of the anti-retroviral drug zidovudine was studied in purified human peripheral blood monocytes. Zidovudine concentrations sufficient for complete inhibition of HIV replication did not affect rIL-3 induced monocyte proliferation. Although rIL-3, like rGM-CSF, was able to augment HIV expression in monocytes, it did not interfere with the anti-retroviral activity of zidovudine. These data indicate that rIL-3 is a potential candidate for use in myelosupportive therapy in AIDS patients treated with anti-retroviral drugs.