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• W2090428934 abstract "One hundred thirty-seven patients with aplastic anemia who survived on maintenance and androgen therapy at the 20th month after initial evaluation have been further followed for one to eight years. Most were improved, or clinically cured, at the end of the full-dose androgen therapy phase. Mortality was 16 percent (actuarial evaluation). Most deaths occurred before the third year, in aged patients showing little or no improvement. Some occurred later, however, during relapse or in patients who survived despite therapy failure. Only one of these 137 patients died from acute leukemia. Six cases of paroxysmal nocturnal hemoglobinuria were noted three to 10 years after initial evaluation. The survival curve tended to plateau after the sixth year. Relapses were observed in about 50 percent (actuarial evaluation) and occurred between the third and 40th month after androgen withdrawal was begun, and earlier when withdrawal was rapid. Relapse was more frequent when initial remission had been partial, sometimes limited to the platelet line but usually similar to the initial situation. In most cases, relapse responded to androgen therapy. A second relapse following a second withdrawal of androgens demonstrates androgen-dependency. After the sixth year, 92 percent of the 68 patients had normal hemoglobin levels, but 40 percent had fewer than 2.0 × 109 granulocytes/liter and 60 percent had fewer than 150 × 109 platelets/ liter. The possibility of a complete cure of aplastic anemia is then debatable. Some of these patients require permanent androgen therapy to maintain clinical equilibrium. The absence of late death and the normal life of the patients who improved and survived for more than three years, however, suggest that lifespan may be normal despite the necessity for monitoring and, in many cases, for permanent androgen therapy. The frequency of relapse, its relation to the androgen used and the androgen dependency of many patients demonstrate the evident effectiveness of androgen therapy. From a clinical point of view, this report and the preceding reports of the Joint Group indicate that when bone marrow graft is not, or cannot be, used, androgen therapy and monitoring can be effective even in severely ill patients." @default.
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• W2090428934 date "1981-10-01" @default.
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• W2090428934 title "Long-term follow-up in patients with aplastic anemia" @default.
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• W2090428934 doi "https://doi.org/10.1016/0002-9343(81)90204-7" @default.
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