methenolone and Anemia--Aplastic

Topics: Adult; Anabolic Agents; Anemia, Aplastic; Antilymphocyte Serum; Bone Marrow Transplantation; Cyclosporine; Drug Therapy, Combination; Evidence-Based Medicine; Granulocyte Colony-Stimulating Factor; Humans; Immunosuppressive Agents; Japan; Methenolone; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Severity of Illness Index

Topics: Age Factors; Aged; Androgens; Anemia, Aplastic; DNA; Erythropoietin; Female; Hematopoiesis; Humans; Male; Methenolone; Oxymetholone; Prognosis; Remission, Spontaneous; RNA; Testosterone

A therapeutic trial with methenolone (Primobolan) in 19 consecutive patients with different types of refractory anemia is reported. The remission frequencies were: pancytopenia 3/6, bicytopenia 2/4, refractory anemia with hyperplastic marrow 1/5, myelofibrosis 1/4. There was no obvious prolongation of survival in the patients responding. Side-effects were negligible.

Topics: Aged; Agranulocytosis; Anemia, Aplastic; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Liver; Male; Methenolone; Middle Aged; Pancytopenia; Primary Myelofibrosis; Remission, Spontaneous; Virilism

The preliminary results of a prospective study of androgen therapy in the treatment of bone marrow insufficiency in children are reported. This study includes 11 children with the Fanconi syndrome, 21 idiopathic and 3 with toxic aplastic anaemia. Nine patients died early in the course of treatment. Impaired liver function was observed in 28% of patients and virilization in 37% of patients.

Topics: Adolescent; Anemia, Aplastic; Child; Child, Preschool; Clinical Trials as Topic; Fanconi Anemia; Female; Follow-Up Studies; Humans; Liver; Male; Methenolone; Methyltestosterone; Oxymetholone; Testosterone Congeners; Virilism

A 54-year-old female, who had been treated for aplastic anemia by metenolone acetate since 1981, developed a sudden unconsciousness in September 1995. On admission, she was drowny, CT showed a subarachnoid hemorrhage (SAH) in the right Sylvian fissure. Angiography demonstrated a complete occlusion of the superior sagittal sinus. The SAH was assumed to be originated from rupture of the right Sylvian vein, which was irregularly dilated on angiography. The dural sinus thrombosis was thought to be caused by a long term use of metenolone acetate, and it was discontinued. But her platelet count dropped due to the aggravation of aplastic anemia, and she developed repeated hemorrhagic infarction. An active anticoagulant therapy for the dural sinus thrombosis was thought to be inappropriate because she had the aplastic anemia and the hemorrhagic infarction recurred. We have successfully treated this case by mild anticoagulant therapy with nafamostat mesilate (Futhan).

Topics: Anemia, Aplastic; Anticoagulants; Benzamidines; Female; Guanidines; Humans; Magnetic Resonance Imaging; Methenolone; Middle Aged; Sinus Thrombosis, Intracranial; Subarachnoid Hemorrhage; Tomography, X-Ray Computed

A 63-year-old woman was found to have thrombocythemia and was referred to our hospital for further evaluation in September 1990. Peripheral blood showed platelet 170.0 x 10(4)/microliter, WBC 14,900/microliter and Hb 9.8 g/dl. Bone marrow was hypercellular with increased megakaryocytes and normal karyotype. She was diagnosed as essential thrombocythemia (ET), and treated with 2 mg of busulfan daily for 3 months until her platelet count decreased to 33.1 x 10(4)/microliter. Busulfan was given again for 40 days (a total of 80 mg) in another hospital when the platelet count increased to 71.1 x 10(4)/microliter in September 1991. In December 1991, she was admitted to our hospital because of pancytopenia. Examination of blood revealed platelet 0.4 x 10(4)/microliter, WBC 1,800/microliter and Hb 7.0 g/dl with hypocellular marrow. A diagnosis of busulfan-induced severe bone marrow aplasia was made. We administered metenolone acetate 15 mg and G-CSF 300 micrograms daily. Blood transfusions were given frequently. However, no effect was observed during her hospitalization. After discharge, G-CSF 600 micrograms and erythropoietin 24,000 units were continued twice a week in combination with metanolone acetate. Pancytopenia gradually began to improve as of June 1992, and then trilineage recovery was achieved in March 1994 with platelet 13.3 x 10(4)/microliter, WBC 5,500/microliter and Hb 12.1 g/dl. The platelet count has been within the normal range for more than 2 years after recovery.

Topics: Anemia, Aplastic; Busulfan; Erythropoietin; Female; Granulocyte Colony-Stimulating Factor; Humans; Methenolone; Middle Aged; Remission Induction; Thrombocythemia, Essential

Topics: Aged; Anabolic Agents; Anemia, Aplastic; Fatal Outcome; Female; Humans; Liver; Methenolone; Peliosis Hepatis

Topics: Anemia, Aplastic; Cholestasis; Humans; Male; Methenolone; Middle Aged; Remission Induction

A 75-year-old man suffering from severe aplastic anemia was treated first with cyclosporin A, then with steroid pulse therapy, and subsequently with metenolone acetate. Marked elevation of transaminases was detected following initiation of treatment with metenolone acetate. This was followed by hepatic failure and death. Histopathological findings in autopsy specimens were compatible with the diagnosis of drug-induced liver impairment, for which metenolone acetate was considered the most likely causative agent. Liver impairment as a side effect of the use of this drug has been thought to be mild, reversible and rather infrequent. However, as demonstrated in the case described here, it is apparent that extreme caution should be exercised when using this drug in debilitated patients.

Topics: Aged; Anemia, Aplastic; Hepatic Encephalopathy; Humans; Male; Methenolone

A 7-year-old boy was admitted to our department complaining pale face and subcutaneous bleeding in August, 1987. Peripheral blood analysis showed pancytopenia of WBC 2,600/microliter, RBC 148 x 10(4)/microliter and platelets 5,000/microliter. Bone marrow biopsy revealed hypocellularity. Granulocytes 104/microliter, reticulocytes 4,290/microliter and platelets 5,000/microliter were compatible with the diagnosis of severe aplastic anemia based on the criteria of the Ministry of Public Welfare in Japan. Prednisolone (PDN) was initially indicated and bolus methylprednisolone, metenolone and ALG therapy followed with no hematological improvement. Fifteen months after admission, in addition to 0.5-1 mg/kg/day of metenolone, Cyclosporin A (CyA) was started at a dose of 12 mg/kg/day for a week and 6 mg/kg/day thereafter. After a week from administration of CyA, 1 mg/kg/day of PDN was given because his bleeding tendency became worse. But this combination was complicated with liver damage and hyperglycemia to discontinue both drugs. These adverse effects were subsided within 7 days by cessation of the drugs. CyA was started again at a dose of 6 mg/kg/day without any response for 4 weeks. Then PDN was added together at a reduced dose of 0.5-1 mg/kg/day. Hematological response was obtained promptly. Granulocytes reached 1,500/microliter, hemoglobin 10.2 g/dl and platelets 26,000/microliter after 3 months of therapy. Afterward the patient became transfusion independent. The most effective method of CyA administration for aplastic anemia is still controversial. Alternative use of CyA, considering combination of steroids or anabolic steroids, in patients who failed to respond to conventional immunosuppressive treatments should be further investigated.

Topics: Anemia, Aplastic; Child; Cyclosporins; Drug Therapy, Combination; Humans; Male; Methenolone; Prednisolone; Remission Induction

Of 27 patients with hypoplastic anemia treated between 1971 and 1974 with male hormone and protein-assimilating hormone, 3 developed superior sagittal sinus thrombosis (SSST). The clinical symptoms and signs and angiographic findings of SST were characteristic enough to allow an early diagnosis. Signs related to SST were seizures, hemiplegia, facial palsy, stupor, and coma, with the most important prodrome and consistent subjective complaint being headache. Following discontinuation of the hormone therapy, neurological signs and symptoms related to SSST gradually subsided. In all cases, the hematological picture improved with discontinuation of the hormone therapies. It appears that administration of male hormone can be associated with the development of SSST. If neurological symptoms and signs of SSST appear, administration of the hormones should be discontinued.

Topics: Adult; Anemia, Aplastic; Cranial Sinuses; Female; Fluoxymesterone; Humans; Intracranial Embolism and Thrombosis; Male; Methenolone; Middle Aged; Oxymetholone; Testosterone; Thrombophlebitis

For the development of an aplastic anaemia a large number of causes is taken into consideration. In our own clinical material of 26 patients in 15 patients none of the up to now known noxae could be established. Recently in the clarification of the picture of the disease important pathophysiological realizations were got. In these cases disturbances of the stem cell compartments, effects through the matrix of the haematopoietic cells and immunological processes have been recognized as significant. --Own investigations concerning the therapy with the anabolic metenolonenanthat (Primobolan-S) yielded approximately the same large number of therapeutic failures and patients with a good result of the treatment or a partial remission in 15 idiopathic and 11 toxically conditioned anaemias. In the partial remissions in most cases a thrombocytopenia continued existing. A therapy lasting at least two months is necessary in order to estimate the result of the therapy. At the present time cannot yet be predicted on which conditions the use of anabolics will be successful.

Topics: Anemia, Aplastic; Autoantibodies; Bone Marrow Cells; Cell Differentiation; Hematopoiesis; Hematopoietic Stem Cells; Humans; Methenolone

Twenty-eight unselected patients with histologically proven aplastic anaemia were electively treated with anabolic steroids (75-150 mg orally q.d.) Additional supportive treatment with blood cell components and antibiotics was given if indicated. Response to therapy was defined as favourable if after 3 months of anabolic therapy overt bleeding tendency had disappeared, there was no need for transfusion therapy, a spontaneous increase of haemoglobin had occurred of greater than 3 g/dl above the initial level, and a platelet rise of twofold the initial count (up to at least greater than 30 x 10(9) /L) had occurred. Of 22 patients evaluable for the results of long-term (greater than 3 months) anabolic treatment, six showed a partial response and eleven responded favourably. These 11 are all alive at the end of the study. Five of these patients proved to be anabolic steroid-dependent. The 50% actuarial survival is approximately 4 years after diagnosis, which compares favourably with the best published results from bone marrow transplantation for aplastic anaemia. It is concluded that anabolic therapy in aplastic anaemia should be tried for 2-3 months before the bone marrow transplantation or immunosuppressive therapy is taken into consideration.

Topics: Adolescent; Adult; Aged; Anemia, Aplastic; Blood Transfusion; Female; Hematopoiesis; Hemoglobinometry; Humans; Male; Methenolone; Middle Aged; Oxymetholone

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.

Topics: Androgens; Anemia, Aplastic; Blood Cell Count; Drug Evaluation; Glucocorticoids; Hemoglobins; Humans; Methandrostenolone; Methenolone; Norethandrolone; Oxymetholone; Prognosis; Prospective Studies; Time Factors

The prognostic factors of short- and long-term survival have been studied in 352 patients with aplastic anemia of all grades of severity. This group was homogeneous with regard to the clinical and laboratory survey, and the treatment used [high-dose androgen therapy]. The "hierarchy" of the individual prognostic parameters has been established: current severe infection, granulocyte count, percentage of the nonmyeloid cells on the bone marrow slides, platelet count, reticulocyte count, 59Fe utilization, and stromal disorganization on the bone marrow biopsy specimen. As these parameters are interrelated, a multiparametric analysis enables us to define groups of patients with different short-term evolution and to derive a prognostic index from these data. The use of such an index, however, allows a correct prediction in only 73 per cent of the cases, better in the milder than in the more severe cases. It is possible that the short-term evolutive tendency (improvement or worsening during the first six weeks of therapy) may contribute supplementary information useful for prognosis and the choice of treatment. After the first three months critical period, the mortality rate no longer depends on the initial severity of the disease but exclusively on the clinical and hematologic improvement. Thus, comparing the hematologic data obtained initially and after three months of androgen therapy allows us to correctly predict the long-term evolution.

Topics: Aged; Anemia, Aplastic; Female; Humans; Male; Methandrostenolone; Methenolone; Middle Aged; Norethandrolone; Oxymetholone; Prognosis

Topics: Adolescent; Adult; Androstanes; Anemia, Aplastic; Female; Fluoxymesterone; Humans; Male; Methenolone; Middle Aged; Oxymetholone; Prospective Studies; Remission, Spontaneous; Time Factors

Topics: Adolescent; Adult; Aged; Anemia, Aplastic; Drug Therapy, Combination; Female; Humans; Male; Methenolone; Middle Aged; Oxymetholone; Prognosis; Remission, Spontaneous

The serum alpha-fetoprotein concentration was measured by radioimmunoassy in 41 women with or without hormonal contraception, 21 patients with rheumatoid arthritis given corticosteroids or not, and 6 patients under androgen therapy for aplastic anemia. None of these therapies induced any significant variation of the serum alpha-fetoprotein level. More extensive studies are needed to investigate the possible effect of these hormones on the metabolism of this protein at a cellular level.. Serum alpha-fetoprotein concentration was measured by radioimmunoassay in 41 women with or without hormonal contraception, 21 pateints with rheumatoid arthritis given corticosteroids or untreated, and 6 patients under androgen therapy for aplastic anemia. The various therapies were ineffective in inducing any change in alpha-fetoprotein level. Future research should focus on the metabolism of this protein at a cellular level in the presence of these hormones.

Topics: Adult; alpha-Fetoproteins; Anemia, Aplastic; Arthritis, Rheumatoid; Estrogens; Female; Hormones; Humans; Methenolone; Methylprednisolone; Progesterone

The effect of conservative treatment of aplastic anaemia was evaluated retrospectively in 40 patients. No significant beneficial effect was provided by long-term high-dose oxymethalone in 20 patients or by metenolone, adrenstonolone, or testosterone in 14 patients. Splenectomy gave no improvement in the majority of cases, although in some it decreased the transfusion requirement. Immunosuppressive treatment was successful in 1 patient with a positive LE phenomenon. Until a specific treatment becomes available, the possibility offered by alternative treatment, e.g. bone marrow transplantation, in cases with poor prognostic parameters should be considered.

Topics: Adolescent; Adult; Aged; Androstenols; Anemia, Aplastic; Evaluation Studies as Topic; Female; Humans; Male; Methenolone; Middle Aged; Oxymetholone; Retrospective Studies; Splenectomy; Testosterone

Two types of chromosome abnormalitie are observed in the bone marrow and the blood of a patient with Fanconi's anemia. There abnormalities involved in two stages: firstly the presence of a clone with 47 chromosomes + 21, which was not found during later examinations. One and a half years later, following a decline in the hematological condition, there appeared duplication of certain chromosome segments of the long arm of the 3 chromosome and of the intermediate segment of the long arm of the 12 chromosome. This latter type of abnormality affected differently the bone marrow and the blood in the bone marrow, we found 2 clones, one bore 2 markers obtained from 3 and 12, the other and marker obtained from the 12 chromosome. In the blood, there was simply a minority clone with only the marker originating in the 3 chromosome. This observation should be compared with the descriptions made by other authors. In all cases abnormal clones present an apparently unbalanced karyotype, characterised by excess material.

Topics: ABO Blood-Group System; Anemia, Aplastic; Bone Marrow; Bone Marrow Cells; Child; Chromosome Aberrations; Chromosomes, Human, 1-3; Chromosomes, Human, 6-12 and X; Clone Cells; Diploidy; Fanconi Anemia; Glucocorticoids; Humans; Karyotyping; Male; Methenolone

Topics: Adolescent; Adult; Aged; Anabolic Agents; Anemia, Aplastic; Blood Cell Count; Female; Humans; Male; Methandrostenolone; Methenolone; Middle Aged; Nandrolone; Oxymetholone; Prednisolone

Topics: Adult; Anemia, Aplastic; Bone Marrow; Bone Marrow Cells; Cells, Cultured; Erythropoietin; Female; Humans; Methenolone

Topics: Adult; Aged; Anemia, Aplastic; Bone Marrow Examination; Busulfan; Child, Preschool; Cholestasis; Female; Humans; Male; Megakaryocytes; Methenolone; Middle Aged; Multiple Myeloma; Remission, Spontaneous

Topics: Androstanes; Anemia, Aplastic; Bone Marrow Examination; Female; Fetal Hemoglobin; Follow-Up Studies; Humans; Male; Methenolone; Oxymetholone; Prognosis; Remission, Spontaneous

Topics: Adult; Anemia, Aplastic; Blood Cell Count; Blood Transfusion; Bone Marrow Examination; Child; Diagnosis, Differential; Humans; Infant; Iron; Methenolone; Oxymetholone; Prednisone; Reticulocytes

Topics: Acetates; Anemia, Aplastic; Anti-Bacterial Agents; Blood Transfusion; Drug Synergism; Hepatitis A; Methenolone; Prednisolone; Sepsis; Staphylococcal Infections

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Amenorrhea; Anabolic Agents; Androstanols; Anemia, Aplastic; Blood Platelets; Erythrocytes; Female; Humans; Jaundice; Leukocytes; Male; Methandrostenolone; Methenolone; Middle Aged; Oxymetholone; Prognosis; Reticulocytes; Virilism

Topics: Adult; Aged; Anemia, Aplastic; Bone Marrow Diseases; Cortisone; Drug Synergism; Female; Humans; Leukemia; Leukopenia; Male; Menopause; Methenolone; Middle Aged; Thrombocytopenia