ISSN 1866-8836
Клеточная терапия и трансплантация

HA-05. Long-term results of immunosuppressive therapy in patients with aplastic anemia

Irina A. Tsopova, Erbol M. Sadabaev, Sagynaly M. Mamatov, Irina E. Kononets

Kyrgyz State I. K. Akhunbaev Medical Academy, Bishkek, Kyrgyz Republic

Contact: Dr. Irina A. Tsopova, phone: +996 (555) 932334, e-mail

doi 10.18620/ctt-1866-8836-2022-11-3-1-132


Aplastic anemia (AA) is a rare severe blood disease characterized by pancytopenia and aplasia of bone marrow due to profound deficiency and functional defects of hematopoietic stem cells. In Kyrgyzstan, immunosuppressive therapy (IST) with equine antithymocytic globulin (ATGAM)+ Cyclosporine A is used to treat aplastic anemia since 2010. The incidence of AA in Asia is 2-3 times higher than in Western countries, where it is 1-2 cases per 1 million population per year. Our purpose was to assess results of long-term treatment in the patients over 60 years old with severe aplastic anemia against IST (ATGAM+Cyclosporine A).

Materials and methods

18 patients with severe aplastic anemia (SAA). Of these, there were 11 males and 7 females. The median age was 64 years (60-74 years). IST treatment protocol (ATG+Cyclosporine A) was as follows: 20 mg ATG per 1 kg body weight for 1-5 days, 10 mg Cyclosporine A\kg body weight on day 20. The median follow-up time for patients was 36 (3-72) months.


Clinical and hematologic improvement after the first course of IST was observed in 13 patients (72.2%), response was absent in the remaining 5 (27.8%) patients, including one patient with extra-severe AA. None of the patients had complete or partial remission. After 12 months of the first course of IST, complete remission occurred in 3 (16.6%) patients, partial remission in 5 (27.7%) patients, clinical and hematological improvement was observed in 5 (27.7%) patients. In four patients (22.2%) out of 5 among those where there was no effect after the first course, the situation did not change. Event-free survival within the next 12 months was observed in 13 patients (72%).


Pathogenetic therapy of ATG + Cyclosporine A in patients over 60 years old has been implemented in Kyrgyzstan. It has shown good results being recommended for usage in AA treatment protocols in the Kyrgyz Republic.


Aplastic anemia, elderly, immunosuppressive therapy, antithymocytic globulin, cyclosporine A.

Volume 11, Number 3

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doi 10.18620/ctt-1866-8836-2022-11-3-1-132

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