1.1.5.1.4 Immunosuppressants

1.1.5.1.4 Immunosuppressants

First, antilymphocyte globulin (ALG) and antithymocyte globulin (ATG): These agents kill suppressive T cells (Ts), CD8⁺ cells, and restore the normal CD4⁺/CD8⁺ ratio, while also possessing mitogenic effects that promote cell proliferation, thereby improving and restoring hematopoietic function in severe aplastic anemia.

Second, cyclosporin A (cyclosporin): It suppresses T cells and reduces IL-2 activity, serving as an immunosuppressive agent. It is particularly effective in treating severe aplastic anemia (SAA), and even patients unresponsive to ALG/ATG therapy can benefit from it, making it the first-line treatment for SAA.

Third, cyclophosphamide (CTX): A potent immunosuppressant routinely used as pre-treatment for allogeneic bone marrow transplantation (allo-BMT) in severe aplastic anemia patients. Reports indicate that a small number of severe aplastic anemia patients, after receiving high-dose cyclophosphamide pre-treatment without undergoing allo-BMT, regained their own hematopoietic function.