Article

[Prognostic factors of immunosuppressive therapy in children acquired aplastic anemia].

Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Zhonghua er ke za zhi. Chinese journal of pediatrics 08/2009; 47(8):613-6. pp.613-6
Source: PubMed

ABSTRACT To investigate prognostic factors of immunosuppressive therapy (IST) in children acquired severe aplastic anemia(SAA).
Data of 56 consecutive children cases with SAA who had received rabbit anti-thymocyte globulin (R-ATG) [3-5 mg/( kg x d) x 5 d] and cyclosporine A (CSA) from January 2000 to June 2006 were retrospectively analyzed. No repeated courses of R-ATG were given for nonresponders. All the patients also received stanozolol or testosterone propionate. The dose of CSA was adjusted to maintain trough drug levels above 100 microg/L and peak drug levels above 300 microg/L.
The overall response rate to the immunosuppressive therapy (IST) was 62.5% and the complete remission rate was 37.5%. The 5-year overall survival for IST regimens was 66.27% +/- 6.84%, patients who had infections when using ATG had significantly lower response and higher mortality. Patients whose nucleated erythrocyte population in bone marrow was > or =10% had good prognosis. Patients whose granulocytes population in bone marrow was > or =10% had lower mortality.
Patients who had infections when using ATG had significantly lower response and higher mortality. Patients whose nucleated erythrocyte population in bone marrow was > or =10% had good prognosis.

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Keywords

5-year
 
56 consecutive children cases
 
complete remission rate
 
cyclosporine
 
granulocytes population
 
higher mortality
 
nonresponders
 
nucleated erythrocyte population
 
patients
 
peak drug levels
 
prognostic factors
 
rabbit anti-thymocyte globulin
 
repeated courses
 
response rate
 
severe aplastic anemia(SAA)
 
testosterone propionate
 
trough drug levels