Efficacy of danazol in pure red cell aplasia

Lippman, Scott M.; Durie, Brian G.M.; Garewal, Harinder S.; Giordano, Gerald F.; Greenberg, Bernard R.

doi:10.1002/ajh.2830230409

Cited by 13 publications

(3 citation statements)

References 19 publications

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“…Danazol, a type of synthetic anabolic steroid [1], has unique properties similar to those of corticosteroids [2,3] such as inhibition [4] of both interleukin-1 and TNF-a production, and has been successfully used for treatments of ITP (immune thrombocytopenic purpura) [5,6], AIHA (autoimmune hemolytic anemia) [7,8], pancytopenia associated with SLE (systemic lupus erythematosus) [9], and pure red cell aplasia [10]. Several case reports have documented the efficacy of danazol in the treatment of AA refractory to IST.…”

Section: Introductionmentioning

confidence: 99%

Danazol therapy for aplastic anemia refractory to immunosuppressive therapy

et al. 2007

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Although there are anecdotal reports of the efficacy of danazol in the treatment of aplastic anemia (AA), there has been no systematic study to clarify its efficacy and toxicity. Therefore, we assessed the efficacy of danazol for treatment of patients with AA refractory to immunosuppressive therapy (IST) and those who relapsed after IST, in a prospective clinical trial. Sixteen patients (12 males and four females; six severe cases and 10 moderate cases) were treated with 300 mg of danazol daily for 12 weeks. All patients completed the treatment period without occurrence of severe toxicity. Three female patients achieved partial remission, whereas only two of the 12 male patients did so. None of the responders had shown a response to previous IST or an increase in the percentage of paroxysmal nocturnal hemoglobinuria (PNH)-type cells which are known to be a marker for a good response to IST. These findings indicate that danazol is effective for a subset of AA patients, and particularly for female patients with AA refractory to IST. Am. J. Hematol. 83:387-389, 2008. V

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Section: Introductionmentioning

confidence: 99%

Danazol therapy for aplastic anemia refractory to immunosuppressive therapy

et al. 2007

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“…Danazol, a synthetic attenuated androgen, has been used widely for anemia in variety of disorders, including pure red cell aplasia, autoimmune hemolytic anemia, aplastic anemia, and IMF [9][10][11][12][13][14]. Cervantes et al [15] reported 30 IMF patients who took danazol for 20.5 months and 11 patients (37%) achieved complete remission (transfusion cessation with normal hemoglobin level).…”

Section: Discussionmentioning

confidence: 98%

Dramatic remission of anemia after thymectomy in a patient of idiopathic myelofibrosis with thymoma

et al. 2007

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Anemia is one of the characteristics of idiopathic myelofibrosis (IMF), and malignant thymoma is usually associated with various hematologic disorders, including anemia, pancytopenia, and hypogammaglobulinemia. However, the relationship between IMF and malignant thymoma has not been published before. Here, we report a 48-year-old woman who was initially diagnosed of IMF with severe anemia and transfusion dependent. Five years later, malignant thymoma was found when she was examined for chronic cough. After performing extended thymectomy, her anemia dramatically recovered to normal and sustained for 2 years till last follow-up. Her splenomegaly and myelofibrosis were also improved. We hypothesized that her malignant thymoma induced the progression of IMF, especially in anemia.

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“…The predominance of plasma cells and plasmacytoid lymphocytes in biopsy samples, together with the finding of a polyclonal hypergamaglobulinemia, led Lukes and Tindle to suggest that AILD is an hyperimmune proliferation of B cells4 No causative agent responsible for this florid B-cell reaction, however, has been identified.6 Viral infections, especially human T-lymphotropic virus (HTLV-l), can produce a similar picture, but studies from this center have not found the HTLV-1 infection in the Indian population. 20 Although the value of danazol in various hematologic disorders has been established, its whether it is safe over the long-term and the optimal dosage are not known. Experience with long-term danazol therapy in hereditary angioneurotic edema suggests that most side effects are dose related; with low dosages (< 200 mg/day), adverse effects are rare.22 To minimize the side effects and reduce the expense, we reduced the dose of danazol(200 mg/day) early in the course of therapy.…”

Section: Discussionmentioning

confidence: 99%

Danazol in treatment of angio-immunoblastic lymphadenopathy

Banavali

Parikh

Charak

et al. 1989

Cancer

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The clinical manifestations of angio-immunoblastic lymphadenopathy (AILD) suggest that there is an abnormality in the immune system. Most patients with AILD die from opportunistic infections associated with lymphocyte depletion. As chemotherapy further increases the already high susceptibility of infections, the therapeutic management of AILD is difficult. The achievement of complete remission (CR) by the patient described here using a danazol-based regimen raises the hope that treatment of this disease with a noncytotoxic drug may be possible. The rationale behind and advantages of using danazol are discussed.Cancer 64:613-615, 1989. NGIO-IMMUNOBLASTIC LYMPHADENOPATHY(AILD)A is a lymphoproliferative disorder characterized by generalized lymphadenopathy, fever, skin rash, and evidence of hyper-immunity, such as polyclonal hyperglobulinemia and frequent Coomb's positive hemolytic anemia. ' The characteristic morphologic features include a loss of the normal nodal archltecture due to a branching network of small blood vessels, accompanied by an infiltration of a range of cells of the lymphoplasmacytic series, most notably immunoblasts and interstitial deposits of granular acidophilic The etiology and pathogenesis of AILD remains unclear, the role of cytotoxic drugs in its therapy is also controversial.2 Because of the presence of immune dysfunction,' it appears to be reasonable to use an immune modifier to treat AILD. Following, a patient successfully treated with a noncytotoxic drug, danazol, is described. The rationale and advantages of this therapy are discussed Case Report A 45-year-old woman presented at Tata Memorial Hospital, Bombay, India who had a 4-month history of fever, loss ofweight, generalized lymphadenopathy, skin rashes, and itching all over the body. She had been on nonspecific treatment for the previous 4 months, which included antibiotics, oral ibuprofen (600 mg/ d for 2 1 days), and prednisolone 30 mg/d for 1 month without any benefit. Physical examination revealed mild fever and pallor.From the

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Efficacy of danazol in pure red cell aplasia

Cited by 13 publications

References 19 publications

Danazol therapy for aplastic anemia refractory to immunosuppressive therapy

Danazol therapy for aplastic anemia refractory to immunosuppressive therapy

Dramatic remission of anemia after thymectomy in a patient of idiopathic myelofibrosis with thymoma

Danazol in treatment of angio-immunoblastic lymphadenopathy

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