Abstract:
Aplastic anaemia is a bone marrow stem cell disorder possibly of
immunological origin. Several immune modifying agents have been subjected to
clinical trials with varying degrees of success. Anti lymphocytic globulin (ALG)
is either horse or rabbit globulin (anti-bodies) against lymphocytes. The present
study is the first of its use in SriLanka. Seven patients (6males) with amean age of
28, 2 years, were included in this study. Severe aplastic anaemia had been
diagnosed in these patients. For a period more than 6 months. Transfusion
requirement was assessed during this period. Bone marrow aspiration and biopsy
had been done to exclude myelofibrosis or malignant infiltration.A5 day course of
ALG (Merieux) was used in all patients. The infusion of ALG was proceeded by
10mg/kg of oral prednisolone on all 5 days and prednisolone was tailed off over a
month. Androgens were given from day 26. None of these patients developed
anaphylaxis. Blood counts were performed daily in the first week and weekly
thereafter for a period of 6 months. Patients were in complete remission if they
had self sustaining normal counts, partial remission if there was an improvement
of counts and decrease of transfusion requirements. Treatment failures were those
in whom there was no improvement in the above indices. Final assessment was
done at 3 months. Two patients had complete remission. 3 had partial remission
and 2 failed to respond to ALG therapy
