Cyclosporine is an immunosuppressive drug that works by preventing T-lymphocytes from becoming active. Once the T-lymphocytes are turned off, they stop attacking stem cells in the bone marrow. That means stem cells may be able to grow back. It is used along with antithymocyte globulin (ATG) as a standard treatment for aplastic anemia, and may also be used to treat MDS and PNH.
Some aplastic anemia patients may require prolonged ongoing treatment with cyclosporine to prevent or minimize the risk of disease relapse aplastic anemia coming back. Generally speaking, patients can remain on cyclosporine indefinitely, as long as there is evidence that the drug is providing some benefit and there are no unwanted or adverse side effects.
For patients who respond well to cyclosporine, alone or in combination with antithymocyte globulin (ATG), hematologists may reduce the cyclosporine dosage. Tapering, or reducing, the dosage is done slowly over a long period of time. If low blood counts and disease symptoms return, your doctor may increase or restart cyclosporine. For those who experience bad side effects such as kidney toxicity, the drug must be discontinued.