High dose intravenous glucocorticoid in the treatment of childhood acquired aplastic anaemia

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Abstract
Children (31) with acute acquired aplastic anemia were treated with very high doses of i.v. bolus methylprednisolone. In 3 of them, paroxysmal nocturnal hemoglobinuria was diagnosed. The responses of 28 patients were evaluated. Normoblastemia and reticulocytes were observed on about the 6th d [day] and leukeocyte and granulocyte response around the 11th d of treatment. The 1st Hb (.gtoreq. 0.5 g/dl) and hematocrit elevations were documented on about the 16th d and the initial platelet response (average .gtoreq. 34 .times. 109/l) took more than a mo. At least 64% of the patients responded to this treatment including 2 cases in whom aplasia was observed following hepatitis. Although 10 episodes of recurrences occurred in 8 patients (with the exception of 3 patients'' in whom 5 recurrences were observed), response to the same regimen was obtained. With 1 exception the side-effects of this treatment could be managed by decreasing the dose. With this treatment, acquired aplastic anemia should no longer be considered a fatal disease, at least in children.