In México, only few patients can afford adequate treatment for aplastic anemia. In a single institution 61 individuals with severe aplastic anemia (SAA) were identified; of these, 33 were followed for at least 3 months, 26 could be treated with immunosuppression (IS), 20 with antithymocyte globulin and cyclosporin A (ATG + CyA) and 6 with CyA, whereas 7 individuals were given only anabolic androgens. In the patients treated with IS a complete remission was achieved in 12 and a partial remission in 6, the overall response rate being 69%. The 5,729-day overall survival (SV) was 54%; it was superior for the patients who received both ATG and CyA (58 vs. 50%). These data contrast with those of the patients who were given only androgens: 14% SV at 5,510 days. Within the group of patients who received IS, one developed acute myelogenous leukemia, another paroxysmal nocturnal hemoglobinuria and another a primary Sjögren’s syndrome-associated low-grade, B cell, non-Hodgkin’s lymphoma. Two individuals who received IS were allografted from HLA-identical siblings and survived 70 and 413 days after the allograft. On the other hand, we also found that, for several reasons, mainly economic ones, only 41% of individuals with SAA finally benefited from the best immunosuppressive therapeutic approach. IS was a good therapeutic choice for some patients with SAA, clearly better than androgen treatment.

Ruiz-Argüelles GJ: Hipoplasias y displasias medulares; in Ruiz-Argüelles GJ (ed): Fundamentos de Hematología, ed 2. México, Editorial Médica Panamericana, 1998, pp 105–114.
Young NS: Acquired aplastic anemia; in Schechter GP, Berliner N, Telen MJ (eds): Hematology 2000. Washington, The American Society of Hematology Education Program Book, 2000, pp 18–38.
Ruiz-Argüelles GJ, Díaz-Jouanen E: ¿Existen formas autoinmunes de aplasia medular? Rev Invest Clin Méx 1979;32:195–196.
Ruiz-Argüelles GJ, Katzmann JA, Greipp PR, Marín-López A, González-Llaven J, Cano-Castellanos R: Lymphocyte subsets in patients with aplastic anemia. Am J Hematol 1984;16:267–275.
Delgado-Lamas JL, López-Karpovitch X, Marín-López A, Romero-Garcia F, Ruiz- Argüelles GJ, Ruiz-González DS, Taboada C, Vazquez-Villegas V, Zarzosa ME: Low-doses of high-potency antithymocyte globulin (ATG) in severe aplastic anemia: Experience with the Mexican ATG. Acta Haematol 1989;81:70–74.
Young NS, Maciejewski J: The pathophysiology of acquired aplastic anemia. N Engl J Med 1997;336:1365–1372.
Ruiz-Argüelles A, Ruiz-Gonzalez JDS, Presno-Bernal M: Preparation and characteristics of an equine anti-human thymocyte gamma globulin produced in México. Rev Invest Clin Méx 1986;38:273–278.
Gómez-Almaguer D, Ruiz-Argüelles GJ, Tarín-Arzaga LC, González-Llano O, Jaime-Pérez JC, López-Martínez B, Cantú-Rodríguez OG, Herrera-Garza JL: Non-myeloablative stem cell transplantation in children and adolescents: The Mexican experience. Biol Blood Marrow Transplant 2003;9:157–161.
Kaplan EL, Meier P: Nonparametric estimations from incomplete observations. J Am Stat Assoc 1958;53:457–463.
Sánchez-Medal L, Ruiz-Reyes G: Geographical variation in blood diseases: Latin America; in Weatherall DJ, Ledingham JGG, Warrel DA (eds): Oxford’s Textbook of Medicine. Oxford, Oxford Medical, 1987, pp 268–270.
Romero F: Incidencia de la anemia aplástica en Iberoamérica; in López-Borrasca A, Arocha-Piñango CL, Campos-Guerra C, Parreira A, Pavlovsky S, Ruiz-Argüelles GJ, San Miguel JF (eds): Enciclopedia Iberoamericana de Hematología. Salamanca, Ediciones Universidad de Salamanca, 1992, pp 659–661.
Benítez-Aranda H, Vélez-Ruelas MA, Díaz-Cárdenas S, Sánchez-Valle E, Xolotl-Castillo M, Dueñas-González MT, Mayani H: Incidence of aplastic anemia in a defined subpopulation from México City. Hematology 2002;7:229–232.
Ruiz-Argüelles GJ, Ramírez-Cisneros FJ, Ruiz-Argüelles A, Pérez-Romano B, Morales-Aceves R: Deficiencia de proteínas de superficie ancladas por glucosil-fosfatidil-inositol en células de pacientes mexicanos con hipoplasia medular. Rev Invest Clín Méx 1999;51:5–9.
Sosa R, Córdova MS, Labardini JR: Trasplante de médula ósea en anemia aplástica. Rev Invest Clín Méx 1980;32:49–55.
Ruiz-Argüelles GJ: Allogeneic stem cell transplantation using non-myeloablative conditioning regimens: Results of the Mexican approach. Int J Hematol 2002;76(suppl 1):376–379.
Ruiz-Argüelles GJ: En el tratamiento de leucemia aguda se obtienen resultados tan buenos como en los países desarrollados; sin embargo ... Rev Invest Clin Méx 1990;42:161–163.
Frickhofen N, Heimpel H, Kaltwasser JP, Schrezenmeier H: Antithymocyte globulin with or without cyclosporin-A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia. Blood 2003;101:1236–1242.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.