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  • 1
    Electronic Resource
    Electronic Resource
    Treatment of severe aplastic anemia with antilymphocyte globulin and androgens: A report on 33 patients (1991)
    Springer
    Annals of hematology 63 (1991), S. 89-93 
    Details
    ISSN: 1432-0584
    Keywords: Aplastic anemia ; Immunosuppressive therapy ; Androgens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty-three patients with severe aplastic anemia were treated with antilymphocyte globulin (ALG, Mérieux) and androgens (with or without corticosteroids) between 1981 and 1989; 24 patients (72.7%) were responders after one course of ALG, eight were nonresponders, and only one patient had an early death. Eighteen of the 24 responses occurred within 2 months of ALG treatment. Of note is the good response rate we obtained for very severe aplastic anemia (four responders of five evaluable patients). With a median follow-up of 36 months (range 1–97), a survival rate of 77.6%±1.2% was obtained at 30 months. No predictive factor of survival could be identified except response to treatment (p=0.0001). The duration of the disease before treatment was inversely related to survival, although this difference did not reach statistical significance (p=0.06). Four initial responders relapsed after 14, 24, 38, and 57 months. Three of these patients received a second course of ALG and two responded. In contrast, four of the nonresponders received a second course of ALG, with only one response. Toxicity of androgens was mild. No patient developed a PNH clone or myelodysplastic syndrome. Major toxicity of corticosteroids was femoral osteonecrosis in three patients. In our experience, the combination of ALG and androgens in SAA, with or without corticosteroids, was associated with a higher response rate and better survival than in many previously published reports. This could have been due to the intensive supportive care during the initial weeks of treatment. We suggest that it may also result from the addition of androgens to ALG, although this issue may only be resolved in a randomized study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01707279
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  • 2
    Electronic Resource
    Electronic Resource
    Urinary steroid patterns after short and long term treatment with human chorionic gonadotropin (HCG) of prepubertal boys with undescended testes (1973)
    Springer
    European journal of pediatrics 114 (1973), S. 155-161 
    Details
    ISSN: 1432-1076
    Keywords: Undescended testes ; Human chorionic gonadotropin ; Urinary steroid excretion ; Steroid metabolism ; Androgens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 14 Jungen im Alter von 5–14 Jahren, die an einseitigem oder doppelseitigem Maldescensus testis litten, und 2 Patienten im Alter von 17 und 18 Jahren mit Hypophysenvorderlappeninsuffizienz wurden mit menschlichem Choriongonadotropin (HCG) behandelt. Das HCG wurde bei 6 Probanden in hohen Dosen kurzfristig (3 Tage lang) und bei 10 Probanden in niedrigeren Dosen 2–6 Wochen lang appliziert. Vor und nach der HCG-Kur wurden 3 11-Deoxy C19-Steroide, 4 11-Oxy C19-Steroide und 3 C21-Steroide einzeln im 24 Std-Harn bestimmt. Die Methode ist schon publiziert worden und bestand aus einer Kombination von Papierchromatographie mit colorimetrischer Endpunktsbestimmung. Sowohl nach der Kurzzeit- wie nach der Langzeitbehandlung traten folgende Veränderungen des Steroidmusters im Harn auf: a) Anstieg von C19O2/C19O3, b) Anstieg der relativen Ausscheidung von allo-Tetrahydrocortisol, c) Abfall der gesamt-tetrahydrierten C21-Steroide. Nach Langzeitbehandlung kam es darüber hinaus zu d) Anstieg der 5α/5β-Quotienten der 11-Deoxy C19-Steroide (C19O2) und der 11-Oxy C19-Steroide (C19O3) sowie e) zu einem Anstieg von Dehydroepiandrosteron. Der Einfluß von HCG auf den Steroidstoffwechsel und das Ausscheidungsmuster der Steroide im Harn läßt sich am besten über die Wirkung von Androgenen erklären. Diese werden von den Testes unter dem Einfluß von HCG auch bei präpuberalen Knaben sezerniert.
    Notes: Abstract Fourteen prepubertal boys (aged 5–14 years) with either unilateral or bilateral undescended testes and 2 males (aged 17 and 18 years) with hypopituitarism received human chorionic gonadotropin (HCG) either in high doses for a short (3 day) period (6 subjects) or in low doses for a long (2–6 week) period (10 subjects). Before and after HCG administration three 11-deoxy C19, four 11-oxy C19 and three C21 steroids were individually determined in 24-hour-urines by previously described paper chromatographic colorimetric techniques. After both short and long term treatment with HCG the following changes of urinary steroid patterns occurred: a) increase of C19O2/C19O3, b) increase of percentage of allotetrahydrocortisol, c) decrease of total tetrahydrated C21 steroids. In addition, long term application of HCG resulted in d) increase of 5α/5β of 11-deoxy C19 (C19O2) and 11-oxy C19 (C19O3) steroids, and e) increase of dehydroepiandrosterone. The effects of HCG an steroid metabolism and urinary excretion patterns can be interpreted as being caused by androgens which are produced by the testes during gonadotropic stimulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00440502
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    Paper (German National Licenses)
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