Effective treatment of spleen diseases: A Synthesis of Findings from 13 Studies

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Original Abstract of the Article

Major Research Findings

Several studies have investigated the effectiveness and safety of immunosuppressive therapy for severe aplastic anemia. 12 suggests that Anti-thymocyte globulin (ATG) combined with eltrombopag is the standard immunosuppressive treatment plan, and ATG is the main treatment for severe aplastic anemia. 8 indicated that the combination of E-ATG and CSA is the most effective treatment for SAA patients, resulting in the highest 5-year survival rate. 5 showed that the combined therapy of ALG and CsA resulted in a significantly higher response rate, lower risk of early mortality, and a shorter time to red cell transfusion independence than ALG alone. 9 found that the combination of R-ATG and CSA remains the best option for treating children with SAA, providing a survival advantage at 5 years. 6 demonstrated that the combination of ALG/ATG and CSA, along with hematopoietic growth factors (HGFs), could reduce early infection and mortality rates, thereby improving the response rates in SAA patients. These research findings suggest that ATG combined with cyclosporine A is an effective treatment for severe aplastic anemia.

Treatment Summary

12 states that ATG combined with eltrombopag is the standard immunosuppressive treatment plan. 8 indicates that the combination of E-ATG and CSA is the most effective treatment for SAA patients. 5 showed that the combined therapy of ALG and CsA resulted in a significantly higher response rate, lower risk of early mortality, and a shorter time to red cell transfusion independence than ALG alone. 9 found that the combination of R-ATG and CSA remains the best option for treating children with SAA, providing a survival advantage at 5 years. 6 demonstrated that the combination of ALG/ATG and CSA, along with hematopoietic growth factors (HGFs), could reduce early infection and mortality rates, thereby improving the response rates in SAA patients. These studies suggest that ATG combined with cyclosporine A is an effective treatment for severe aplastic anemia.

Benefits and Risks

Benefit Summary

ATG combined with cyclosporine A may increase the response rate in patients with severe aplastic anemia. 8 , 5 , 9 . It may also reduce the risk of early death and shorten the duration of red blood cell transfusion dependence. 5 . The combination with hematopoietic growth factors may further reduce the risk of early infection and death. 6

Risk Summary

ATG combined with cyclosporine A may increase the risk of infection. 6 . The long-term safety of this treatment is still unknown. 12

Comparison of Studies

Commonalities of Studies

Several studies have shown that ATG is effective in treating severe aplastic anemia. They have also indicated that the combination with cyclosporine A can improve the response rate. Furthermore, the use of hematopoietic growth factors may reduce the risk of early infection and death.

Differences Between Studies

The type, dosage, and duration of ATG administration vary between studies. Additionally, the patient populations and outcome measures differ. Therefore, it is difficult to directly compare the study results.

Consistency and Contradictions of Results

Multiple research findings suggest that the combination of ATG and cyclosporine A is an effective treatment for severe aplastic anemia. However, due to differences in methods and evaluation criteria used in each study, it is challenging to achieve complete consistency. Additionally, the long-term safety of this treatment remains uncertain.

Considerations for Real-Life Application

The combination of ATG and cyclosporine A appears to be an effective treatment option for severe aplastic anemia. However, it is important to note the increased risk of infection and the unknown long-term safety profile. It is crucial to consult with a doctor before undergoing this treatment.

Limitations of Current Research

The long-term safety profile of ATG combined with cyclosporine A is still unknown. Additionally, the differences in methodologies and evaluation criteria between studies make it difficult to completely harmonize the results.

Future Research Directions

Large-scale clinical trials are needed to assess the long-term safety and effectiveness of the combined treatment of ATG and cyclosporine A. Furthermore, research is required to identify the optimal dosage, duration, and combination of therapies.

Conclusion

Multiple studies suggest that the combination of ATG and cyclosporine A is an effective treatment for severe aplastic anemia. However, the increased risk of infection and the unknown long-term safety profile should be considered. It is essential to consult with a doctor before receiving this treatment.

List of Treatments

• Anti-thymocyte globulin (ATG)• Eltrombopag• Cyclosporine A• Hematopoietic Growth Factors

Literature analysis of 13 papers
Positive Content
13
Neutral Content
0
Negative Content
0
Article Type
9
3
3
1
12
1.

Aplastic anemia treated by allogeneic bone marrow transplantation: a report on 49 new cases from Seattle.

Author: StorbR, ThomasE D, WeidenP L, BucknerC D, CliftR A, FeferA, FernandoL P, GiblettE R, GoodellB W, JohnsonF L, LernerK G, NeimanP E, SandersJ E

Aplastic anemia treatment
GVHD
Graft rejection
Infection

Marrow transplantation from HLA-identical siblings was successful in 41% of patients with severe aplastic anemia who did not respond to conventional treatment. The major causes of failure were marrow graft rejection, graft-versus-host disease (GVHD), and infections. Conditioning regimens with cyclophosphamide (CY) or procarbazine-antithymocyte globulin-CY did not affect the incidence of graft rejection.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Severe aplastic anemia: a prospective study of the effect of early marrow transplantation on acute mortality.

Author: CamittaB M, ThomasE D, NathanD G, SantosG, Gordon-SmithE C, GaleR P, RappeportJ M, StorbR

Decreased mortality
Full marrow reconstitution
Graft-versus-host disease

A study of 67 patients with severe aplastic anemia compared early bone marrow transplantation to conventional treatments. Patients who received early transplants (within 33 days of diagnosis) had significantly higher survival rates (24 out of 36 alive after 9 months) and faster recovery of marrow function compared to those receiving conventional treatments (12 out of 31 alive). Early transplantation also significantly reduced the risk of death within the first 3 months. While longer follow-up is needed, early bone marrow transplantation appears to be the most effective treatment for severe aplastic anemia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

3.

Antithymocyte globulin treatment in patients with aplastic anemia: a prospective randomized trial.

Author: ChamplinR, HoW, GaleR P

Improved hematopoiesis
No complete recovery

This study found that antithymocyte globulin was effective in improving hematopoiesis in some patients with aplastic anemia, with 11 out of 21 patients showing sustained improvement within three months, compared to no improvement in the control group.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

4.

[Clinical observation on child aplastic anemia treated with integrated Chinese and Western medicine].

Author: ZhangZ M, ShiB J, FanR

Improved hematopoietic function
Unknown long-term effects

This study found that fetal blood transfusion, Chinese medicinal herbs, and vitamin C were more effective in treating aplastic anemia than Western medicine alone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

5.

[Antilymphocyte globulin combining with cyclosporine A in the treatment of severe aplastic anemia].

Author: ZhengY, ChuY, ShaoZ

Higher response rate
Lower mortality risk

Intensive immunosuppressive therapy (IIST) with antilymphocyte globulin (ALG) and cyclosporine A (CsA) had a higher response rate (83.7%) for severe aplastic anemia (SAA) than non-intensive immunosuppressive therapy (NIIST) with ALG alone (57.6%). IIST also resulted in a lower risk of early mortality and a shorter time to red cell transfusion independence.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

6.

[Sequential intensified immunosuppressive therapy combining with hematopoietic growth factors in the treatment of severe aplastic anemia].

Author: HeG, ShaoZ, ZhangY, LiuH, LiK, SongL, ZhengY, ChenG, HeH, ZhaoM, ShiJ, ZhangH, ChuY, QianL, YangT, YangC

Severe aplastic anemia treatment

The addition of hematopoietic growth factors (HGFs) to sequential intensified immunosuppressive therapy (SIIST) for severe aplastic anemia (SAA) significantly improved response rates and reduced early infection and mortality rates.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Chinese

7.

Antithymocyte globulin with or without cyclosporin A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia.

Author: FrickhofenNorbert, HeimpelHermann, KaltwasserJoachim P, SchrezenmeierHubert,

Cyclosporine effective anemia
Salvage treatment effective
Remission unstable
Secondary disease common

Cyclosporine treatment in patients with aplastic anemia led to a significantly higher response rate (70% vs 41%) compared to treatment without cyclosporine. Patients with cyclosporine also had a faster response time (median 60 vs 82 days) and required fewer courses of immunosuppression. While overall survival was similar between groups, failure-free survival favored the cyclosporine regimen (39% vs 24%). However, relapse rates were similar and remissions were cyclosporine dependent in 26% of patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Immunosuppressive therapy for acquired severe aplastic anemia (SAA): a prospective comparison of four different regimens.

Author: ZhengYizhou, LiuYongze, ChuYulin

Hematopoietic recovery
Increased survival
Early deaths

The combination of equine anti-human thymocyte immunoglobulin (E-ATG) and cyclosporine A is the most effective treatment for acquired severe aplastic anemia, resulting in a survival advantage at 5 years.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

[Efficacy of immunosuppressive therapy in children with acquired aplastic anemia].

Author: WangShu-chun, ZouYao, ChenXiao-juan, YangWen-yu, LiuTian-feng, ZhangLi, ChenYu-mei, GuoYe, ZhuXiao-fan

Improved SAA survival
None reported

This study found that the combination of R-ATG and CSA remains the best treatment for children with SAA who have no HLA-matched sibling, providing a survival advantage at 5 years.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

10.

First-line matched related donor hematopoietic stem cell transplantation compared to immunosuppressive therapy in acquired severe aplastic anemia.

Author: PeinemannFrank, GrouvenUlrich, KrögerNicolaus, BartelCarmen, PittlerMax H, LangeStefan

SAA treatment

Acquired severe aplastic anemia (SAA) is a rare disease where the immune system attacks blood-forming stem cells. If a matched donor is available, a stem cell transplant is the preferred treatment. Immunosuppressive therapy is an alternative. This study compared the outcomes of these two treatments in controlled trials.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

11.

First-line allogeneic hematopoietic stem cell transplantation of HLA-matched sibling donors compared with first-line ciclosporin and/or antithymocyte or antilymphocyte globulin for acquired severe aplastic anemia.

Author: PeinemannFrank, BartelCarmen, GrouvenUlrich

Aplastic anemia treatment

Acquired severe aplastic anemia is a rare and potentially fatal blood disorder characterized by a lack of blood cells due to a problem with the bone marrow. Symptoms include infections, bleeding, and fatigue. The primary treatment is a stem cell transplant from a matching sibling donor. If a matching sibling is not available, medications like ciclosporin or antithymocyte/antilymphocyte globulin are used to suppress the immune system.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

A systematic review and meta-analysis of the safety and efficacy of anti-thymocyte globulin combined with eltrombopag in the treatment of severe aplastic anemia.

Author: ZhangJiayou, WuYabing, LiuJunhui, HanShaolin, ChenLijuan, WangHui, PengYu

Aplastic anemia treatment

Aplastic anemia is a serious blood disorder. The standard treatment often combines anti-thymocyte globulin (ATG) and eltrombopag. While this combination has shown positive results, we need more research to confirm its long-term safety.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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