OBJECTIVE: To investigate the efficacy and safety of stanozolol combined with avatrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with relapsed/refractory tumors. METHODS: Twenty-five patients with relapsed/refractory CIT admitted to the Hematology Department of Xiyuan Hospital, China Academy of Chinese Medical Sciences between March 2023 to December 2023 were enrolled. These patients received a combined therapy of stanozolol and avatrombopag. The clinical efficacy, onset time, changes in platelet levels and blood cell counts before and after treatment, and adverse reactions of patients were evaluated. RESULTS: The combination therapy demonstrated remarkable efficacy with a total effective rate of 100%. Among the 25 patients, 19 achieved complete remission and 6 achieved partial remission. The median onset time was 42.5（range: 35-48）days. The average platelet count of the 25 patients increased from (25.73±17.75)×10⁹/L before treatment to (146.4±49.59)×10⁹/L after 3 months of treatment, with a statistically significant difference ( P < 0.05). 18 patients who previously required platelet transfusion were all weaned off platelet transfusion after 3 months of treatment, with a median time to be free from platelet transfusion was 26 (range: 18-51) days. During the treatment, both neutrophils and hemoglobin exhibited various degrees of elevation. Two patients experienced a slight increase in alanine aminotransferase(ALT) levels, which normalized after treatment with oral hepatoprotective drug. One patient had a PLT increase exceeding 350×10⁹/L, and the treatment with avatrombopag was suspended, and aspirin and other drugs were given to prevent thrombosis. No thrombose events or CIT-related bleeding events were observed in all patients. CONCLUSION The combination therapy of stanozolol and avatrombopag is significantly effective for treating relapsed/refractory CIT patients, with a high response rate and good safety, making it a suitable clinical treatment option.
Humans ; Thrombocytopenia/chemically induced* ; Stanozolol/therapeutic use* ; Male ; Female ; Neoplasms/drug therapy* ; Middle Aged ; Thiophenes/therapeutic use* ; Adult ; Platelet Count ; Treatment Outcome ; Antineoplastic Agents/adverse effects* ; Recurrence ; Thiazoles

OBJECTIVETo evaluate the effect of combined use of stanazolol (ST) on the final adult height (FAH) in girls with idiopathic central precocious puberty (ICPP) and apparently decreased linear growth during gonadotropin-releasing hormone analog (GnRHa) therapy.

METHODSixty-three girls with ICPP and decreased velocity of growth of height (HV<4 cm/yr) during GnRHa therapy were divided into 3 groups based on the following types of interventions:group 1 (n = 20), GnRHa+ST [25-30 µg/(kg·d) every 3-month followed by 3-month discontinuation], group 2 (n = 21), GnRHa+recombinant human growth hormone [rhGH, 1-1.1 U/(kg·w)], group 3 (n = 22), GnRHa alone.HV, the advancement of bone age (BA) for chronological age (CA) (ΔBA/ΔCA) and FAH were compared among groups.

RESULT(1)Total duration of ST combination therapy was (12.22 ± 3.62) months, while total duration of combination of rhGH was (13.22 ± 6.80) months. (2)HV increased significantly in both group 1 [ (2.79 ± 0.60) cm/yr vs. (6.27 ± 1.98) cm/yr, P < 0.01] and in group 2 [(2.80 ± 0.50) cm/yr vs. (6.25 ± 1.98) cm/yr, P < 0.01] during combined therapy, but maintained at low levels in group 3 [(3.95 ± 1.10) cm/yr vs. (3.34 ± 0.95) cm/yr, P > 0.05].No significant differences of ΔBA/ΔCA were found among the three groups [0.25(0.11∼0.28), 0.22(0.15∼0.31),0.19(0.10∼0.32), P > 0.05]. (3)FAH was significantly higher than predicted adult height (PAH) before combined therapy, as well as higher than target height (THt) in both group 1 [(156.25 ± 2.90) cm vs. (150.78 ± 3.70) cm, P < 0.01, (156.25 ± 2.90) cm vs. (153.94 ± 2.62) cm, P < 0.01], and in group2 [ (157.33 ± 4.69) cm vs. (152.61 ± 3.92) cm, P < 0.01, (157.33 ± 4.69) cm vs. (154.39 ± 4.72) cm, P = 0.01].In group 3, FAH was similar to PAH [(153.88 ± 2.6) cm vs. (152.54 ± 5.86) cm, P > 0.05], and was less than THt [(153.88 ± 2.6) cm vs. (155.60 ± 4.52) cm, P = 0.02]. (4)In girls treated with ST, no hirsutism, clitorism or hoarse voice was recorded.No polycystic ovary syndrome was found by B-mode ultrasound.

CONCLUSIONIntermittent combined use of low dose ST therapy can increase HV and thus improve FAH in girls with ICPP and apparently decreased linear growth during GnRHa therapy.

Body Height ; drug effects ; Bone Development ; Child ; Child Development ; drug effects ; Drug Therapy, Combination ; Female ; Gonadotropin-Releasing Hormone ; administration & dosage ; analogs & derivatives ; therapeutic use ; Growth Disorders ; drug therapy ; Human Growth Hormone ; administration & dosage ; therapeutic use ; Humans ; Puberty, Precocious ; drug therapy ; physiopathology ; Stanozolol ; administration & dosage ; therapeutic use ; Treatment Outcome

This study was purposed to assess the efficacy of stanozolol for treatment of childhood patients with acquired non-severe aplastic anemia (NSAA). The records of 114 children with acquired NSAA treated in hospital between January 1996 and January 2009 were analyzed retrospectively. All patients received stanozolol with the dose of 0.1 mg/(kg·d). Some patients were treated with supportive care. The incidence and the risk factors of progression severe aplastic anemia (SAA) including gender, age, absolute neutrophil count, absolute reticulocyte count, dependent or independent of transfusion, the ratio of granulocytes and erythrocytes were evaluated. The results indicated that at a median follow-up of 52 months (range 5 - 181), 6 patients (5.3%) progressed into SAA, 93 (81.6%) remained in NSAA, and 15 (13.2%) had complete remission. Patients with dependent of transfusion (platelet count < 10 × 10(9)/L and/or haemoglobin < 70 g/L) have higher risk to progress into SAA (19.2% vs 1.1%) (p = 0.016); patients with lower absolute neutrophil count (ANC) (< 0.8 × 10(9)/L) or with lower absolute reticulocyte count (ARC) (< 40 × 10(9)/L) at diagnosis have higher risk to progress into SAA (8.1% vs 0%) (p = 0.029); (9.1% vs 1.7%) (p = 0.034); Those patients with lower ANC (ANC < 0.8 × 10(9)/L) and lower ARC (ARC < 40 × 10(9)/L) have higher risk into progress to SAA (19.2% vs 1.1%) (p = 0.016). It is concluded that NSAA patients treated with Stanozolol progress into SAA with the rate of 5.3%. Those patients with dependent of transfusion or ANC < 0.8 × 10(9)/L or/and ARC < 40 × 10(9)/L have higher risk of progress into SAA.
Adolescent ; Androgens ; therapeutic use ; Anemia, Aplastic ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Retrospective Studies ; Stanozolol ; therapeutic use ; Treatment Outcome

OBJECTIVETo observe the clinical efficacy of Qinghuang Powder combined with Chinese herbs for reinforcing Shen and strenghening Pi in treating myelodysplastic syndrome (MDS).

METHODSfifty-five patients with diagnosis fitting to MDS were treated with Qinghuang Powder and decoction for strengthening Pi and reinforcing Shen, in combination with Stanozololum.

RESULTSEleven patients (20.0%) out of the 55 were completely remitted (CR), the total effective rate being 74.5% (41/55 cases). By FAB typing, 9 (26. 5%) in the 34 patients of type RA/RAS were CR, with the total effective rate of 82.4% (28/34 cases), and in the 21 patients of type RAEB, 9.5% (2/21 cases) were CR with the total effective rate of 61.9% (13/21 cases), showing insignificant statistical difference between the two types (P > 0.05). By international prognostic scoring system (IPSS), the treatment was evaluated as CR in 10 patients, effective in 25 and ineffective in 11 in 36 patients of moderate risk group I , the responding numbers were 1, 4, 2 in 7 patients of moderate risk group II and 0, 3, 3 in 6 patients of high risk group, respectively, also showing insignificant difference between groups (P > 0.05). Levels of Hb, WBC and platelet significantly increased after treatment (P < 0. 05). By cytogenetics, the effective rate was 68.8% (11/16 cases) in patients with abnormal chromosome and 72.7% (24/33 cases) in those with normal chromosome, with insignificant difference (P > 0.05).

CONCLUSIONThe comprehensive therapy with TCM treatment for reinforcing Shen and dissolving stasis in dominance has a definite clinical effect in treating MDS, it was not significantly associated with FAB typing, IPSS score, and chromosome abnormality of patients.

Adolescent ; Adult ; Aged ; Anemia, Refractory ; drug therapy ; Arsenicals ; therapeutic use ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; drug therapy ; physiopathology ; Phytotherapy ; Stanozolol ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the therapy to further elevate the efficacy of the treatment of chronic aplastic anemia (CAA).

METHODSForty-five patients with CCA were assigned into two groups, the 26 patients in the treated group were treated by Shengxuening (a Chinese herbal preparation) and cyclosporin A (CsA), and the 19 patients in the control group were treated with androgen alone, with the therapeutic course lasting for over 3 months. Changes of peripheral blood picture, and the colony productivity of burst forming unit-erythroid (BFU-E), colony forming unit-erythroid (CFU-E) and colony forming unit-granulocyte macrophage (CFU-GM) in bone marrow were observed before and after 3 months treatment. The amount of erythrocyte and platelet infusion, frequency of infection, condition of hemorrhage and relevant death were also observed. The follow-up study was conducted for over half a year.

RESULTSThe total effective rate in the treated group was 84.6%, which was significantly higher than that in the control group (52.6%, P < 0.05). Levels of hemoglobin, reticulocyte, neutrophil and platelet increased after treatment in the treated group, as compared with those before treatment, with significant difference (P < 0.05), and the colony productivity of BFU-E, CFU-E and CFU-GM in bone marrow also got significantly increased (P < 0.01), and showed significant difference from those in the control group (P < 0.05).

CONCLUSIONShengxuening-assisting CsA therapy is an effective measure for treatment of CAA.

Adult ; Aged ; Androgens ; therapeutic use ; Anemia, Aplastic ; drug therapy ; Chronic Disease ; Cyclosporine ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Erythroid Precursor Cells ; Follow-Up Studies ; Hemoglobins ; analysis ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Neutrophils ; cytology ; Platelet Count ; Reticulocytes ; cytology ; Stanozolol ; therapeutic use ; Tablets

OBJECTIVETo investigate the effect of Shenmai injection on chronic aplastic anemia patients and its mechanism.

METHODSixty-five chronic aplastic anemia patients were randomized into treatment group and control group. The patients of the treatment group were treated by injecting Shenmai injection and taking western medicine orally, those of the control group taking western medicine orally only, then the effect was evaluated. The concentration of tumor necrosis factor-alpha (TNF-alpha) in blood serum was detected and the apoptosis of bone marrow CD34+ cell was analysed by DNA ISEL technic before and after treatment.

RESULTThe effective rate of the treatment group and the control group was 63.6 % and 40.6 % respectively, the effect of the Shenmai injection on the treatment group was obviously better than that of the control group (P < 0.01). Before treatment, the concentration of TNF-alpha in blood serum and the apoptosis rate of bone marrow CD34+ cell of the chronic aplastic anemia patient were higher than normal (P < 0.01). After treatment, the concentration of TNF-alpha in blood serum of the treatment group decreased obviously (P < 0.01), and the apoptosis rate of bone marrow CD34+ cell of the treatment group also decreased (P < 0.05), which had significant difference compared with those of the control group (P < 0.05).

CONCLUSIONShenmai injection is efficient to chronic aplastic anemia. The mechanism is decreasing the concentration of TNF-alpha in blood serum and the apoptosis rate of bone marrow CD34+ cell.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; drug therapy ; metabolism ; pathology ; Antigens, CD34 ; metabolism ; Apoptosis ; drug effects ; Bone Marrow Cells ; immunology ; pathology ; Child ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Ophiopogon ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Stanozolol ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo observe the effect of Shenfu injection (SFI) and influence on T-lymphocyte subset, serum level of interferon-gamma(IFN-gamma), tumor necrosis factor-alpha(TNF-alpha), interleukin-2(IL-2) in patients with chronic aplastic anemia (CAA) based on treating with stanozol and cyclosporin A.

METHOD60 patients with CAA were randomly divided into two groups, 30 patients in the SFI group were treated with SFI (100 mL which contains Ginsenoside 0.8 mg x mL(-1) and aconitine 1.8 microg x mL(-1) by adding it in 500 mL of 5% glucose every day) plus stanozol and cyclosporin A and 30 patients in the control group treated with slanozol and cyclosporin A alone for 2 months. The clinical efficacy was observed. The change of T-lymphocyte subset analyzed by flow cytometry and the levels of serum IFN-gamma, TNF-alpha, IL-2 measured with ELISA method were also observed before and after treatment.

RESULTAfter treatment, the total effective rate of the SFI group was higher than that in the control group, but it did not showing significant difference. The CD4/CD8 levels were significantly increased (1.76+/-0.49, P< 0.01) and CD8 levels were significantly lowered (22.57+/-6.30, P < 0.01) in the SFI group after treatment. Serum levels of lFN-gamma, TNF-alpha and IL-2 were lower in both groups, and the level of TNF-alpha and IL-2 in the SFI group (0.710+/-0.213) ng x L(-1) and (0.639+/-0.247) ng x L(-1) was significantly lowered than that in the control group (P < 0.05, P < 0.01).

CONCLUSIONSFI might believe the hemopoietic inhibition so as to promote the recovery of hemopoietic function through improving the T-lymphocyte subset and reducing the release of hemopoietic negative regulatory factors such as IFN-gamma, TNF-alpha and IL-2.

Aconitine ; administration & dosage ; Adolescent ; Adult ; Aged ; Anemia, Aplastic ; blood ; drug therapy ; immunology ; CD4-CD8 Ratio ; Cyclosporine ; therapeutic use ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Ginsenosides ; administration & dosage ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Kidney Diseases ; blood ; drug therapy ; immunology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Stanozolol ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism ; Yang Deficiency ; blood ; drug therapy ; immunology