Abstract
Treatment with ceruloplasmin combined with glucocorticoid, anabolic steroids or folic acid was attempted to 5 patients with aplastic amenia. The therapy was at least effective in all cases, including 2 cases with marked efficiency, to improve anemia or to reduce the amount of blood transfusions, suggesting some recovery of erythroid proliferation. The pharmacological mechanism of the hematological improvement was thought to be related to an amelioration of iron utilization, which was interpreted by posttherapeutic increases in plasma iron disapperance rate, plasma iron turnover rate and iron utilization rate on ferrokinetics. Despite clinical improvements, colony count of CFU-C (colony forming unit culture) of the bone marrow cells remained at very low levels along with circulating granulocytopenia and thrombocytopenia even after the therapy, suggesting that cerulopasmin has less proliferative effects on the myeloid series. However, because of its beneficial effect on the erythroid series, treatment with cerulopasmin will be worthwhile to attempt in refractory aplastic anemia.
