ALG/ATG treatment--a useful alternative for BMT in selected aplastic anaemia patients.

8 patients with severe and 4 with non-severe aplastic anaemia, aged 7 to 46 years, whose suppressor lymphocyte activity was in most cases elevated and who had no histocompatible sibling donor, underwent 1-2 courses of ALG/ATG treatment. 6 patients got CR and 1 PR and during 1-4 years they live with sustaining haemopoiesis, independent of blood transfusion (except one in PR). Among these seven responders increased suppressor lymphocyte activity normalized in 6. The adverse effects of the treatment were granulocyto- and thrombocytopenia, subfebrile states, hepatotoxicity, serum sickness and skin allergy. Five patients died because of early or late complications of the treatment or it's failure. Our results, similar to other authors', are like after BMT and supports the immunological mechanism of A.A. Immunosuppressive treatment with ALG/ATG has many advantages: no need to have identical bone marrow donor, no GVHD, possibility of treatment of patients over 30, even pretreated with blood transfusions, and finally much lower costs and efforts.

The results of treatment of selected patients with ANLL with low-dose Ara-C.

Low dose Ara-C (10-15 mg/m2) was administered subcutaneously in 1-5 courses of 14 to 21 days to 16 patients with acute nonlymphoblastic leukaemia, mostly in elderly persons and/or with pancytopenia in whom conventional chemotherapy was contraindicated or ineffective. 18 of the 26 patients were females and 8 males. The mean age was 54.9 years ranging from 31 to 81 years. Mean duration of treatment was 15.2 days. Five complete remissions and three partial remissions were obtained. The mean duration of complete remission was 4.7 months and the mean duration of partial remission was 6.7 months. Aggravation of cytopenia during the treatment and hypocellularity of bone marrow aspirates at the end of therapy suggest that low dose Ara-C exerts its main activity by suppression of leukaemic proliferation rather than by induction of differentiation in malignant cells. Our results show that low dose of Ara-C could be valuable alternative treatment in patients with contraindications or ineffectiveness of conventional intensive chemotherapy.