Androgen therapy of aplastic anaemia--a prospective study of 352 cases

Scand J Haematol. 1979 Apr 4;22(4):343-56.

Androgen therapy of aplastic anaemia--a prospective study of 352 cases.

[No authors listed]

A prospective study of 352 patients with aplastic anaemia on androgen therapy has
been performed. The following main observations have been obtained: The actuarial
mortality rate at the 20th month is 52%, half the deaths being observed during
the first 3 months; these figures are similar to those previously published, from
smaller series of androgen-treated patients, and lower than those of
non-androgen-treated cases. Differences in survival and improvement were observed
between groups of patients treated for more than 3 months with either alkylated
or non-alkylated drugs. Signs of liver damage were observed no matter which was
the drug used. Continous improvement can be observed even in the 2nd year of
treatment indicating that full-dose androgen therapy should be continued up to 20
months in not fully improved patients. The degree of initial disease activity is
a clear prognostic parameter for the mortality in the first quarter of the
course. In case of survival of severe cases, improvement can be obtained to the
same extent as in milder cases. This stress the need for adequate maintenance
therapy in all types of patients. Addition of glucocorticoids harms the
prognosis, mainly in most granulocytopenic patients. Glucocorticoids have no
effect upon the liver damage induced by androgens.