Until recently, the prognosis of refractory anemia could be summarized in the following terms: "Marrow aplasia cannot be reversed by any known means. Supportive therapy with transfusions and antibiotics is usually necessary and, in milder cases, may prolong life until spontaneous recovery of marrow function occurs." 29 With the exception of the rare cases in which splenectomy improved the clinical and hematological picture, the course of the disease was but slightly modified by therapy.17,21,26 The present outlook is brighter since androgenic hormone therapy has been introduced in this condition.31 The testosterone derivatives used (methyltestosterone; testosterone cyclopentylate, enanthate, and propionate; and fluoxymesterone) have several disadvantages consisting of bone-maturating and virilizing actions; some of the derivatives are orally inactive or produce liver damage. In view of this, it seemed advisable to investigate, in patients with medular insufficiency, the therapeutic action of oxymetholone (2-hydroxymethylene-17α-methyldihydrotestosterone), an anabolic hormone with less virilizing activity.
SANCHEZ-MEDAL L, PIZZUTO J, TORRE-LOPEZ E, DERBEZ R. Effect of Oxymetholone in Refractory Anemia. Arch Intern Med. 1964;113(5):721–729. doi:10.1001/archinte.1964.00280110101020
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