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Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin

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Abstract

Objective

To explore the prognostic factors for very severe aplastic anemia (VSAA) patients treated mainly with Chinese Kidney (Shen)-invigorating drugs (CKID) combined with anti-lymphocyte globulin (ALG) or anti-thymocyte globulin (ATG).

Methods

Twenty-seven VSAA patients were treated with CSID+ALG/ATG therapy in conjunction with cyclosporine A, androgen, hemopoietic growth factor, etc. The relationship of the effectiveness and some factors (age of patients, course of illness, blood and bone marrow figures, etc.) were analyzed.

Results

In the 25 evaluated VSAA patients who had been followed up for over 1 year, 9 patients (36.0%) were basically cured, 5 (20.0%) remitted, 6 (24.0%) were markedly improved, and 5 (20.0%) were treated in vain, with the total effective rate of treatment being 80.0% (20/25). Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA, of male sex (P=0.037), >20 years old (P=0.045), with an illness course ⩽ month (P=0.048), with peripheral neutrophil count >0.1 × 109/L (P=0.023), and with reticulocyte count >10 × 109/L (P=0.002). Platelet count (P=0.620) and bone marrow lymphocyte percentage (P=0.736) showed no correlation with the therapeutic effectiveness. Multi-factor analysis by the Kaplan-Meier procedure on the factors influencing survival showed that rather longer survival times occurred in patients > 20 years old, with peripheral neutrophil count ⩽ 0.1 × 109/L, reticulocyte count ⩽10 × 109/L, and platelet count > 10 × 109/L (all P=0.0001). Bone marrow lymphocyte percentage and the initiation time of ALG/ATG application (from onset of the illness) showed no significant influence on patients’ survival time (P=0.085 and P=0.935, respectively).

Conclusions

CSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients’ survival rate. Conditions including male sex, age >20 years, illness course ⩽1 month, neutrophil count >0.1 × 109/L, and reticulocyte count >10 × 109/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.

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References

  1. Tang XD, Zhang SS, Ma R, Xu YG, Yang XH, Xiao HY, et al. Preliminary study on predictors for selection of immunosuppressive therapy or androgens in treating aplastic anemia patients. Chin J Integr Tradit West Med (Chin) 2009;29:106–110.

    Google Scholar 

  2. Zhang ZN, Shen D, eds, Diagnosis and treatment standards for blood diseases. 3rd ed. Beijing: Science Press; 2007:19–23.

    Google Scholar 

  3. Summary of the Fourth National Conference on Aplastic Anemia by Chinese Society of Hematology, Chinese Medical Association. The efficacy and diagnostic criteria for aplastic anemia. Chin J Hematol (Chin) 1987;8:486.

    Google Scholar 

  4. Young NS. Pathophysiologic mechanisms in acquired aplastic anemia. Hematology Am Soc Hematol Educ Program 2006:72–77.

  5. Frickhofen N, Heimpel H, Kaltwasser JP, Schrezenmeier H, German Aplastic Anemia Study Group. Antithymocyte globulin with or without cyclosporin A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia. Blood 2003;101:1236–1242.

    PubMed  CAS  Google Scholar 

  6. Rosenfeld S, Follmann D, Nunez O, Young NS. Antithymocyte globulin and cyclosporine for severe aplastic anemia: association between hematologic response and long-term outcome. JAMA 2003;289:1130–1135.

    Article  PubMed  CAS  Google Scholar 

  7. Locasciulli A, Oneto R, Bacigalupo A, Socié G, Korthof E, Bekassy A, et al. Outcome of patients with acquired apalstic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the Europen Group for Blood and Marrow Transplantation (EBMT). Haematogica 2007;92:11–18.

    Article  CAS  Google Scholar 

  8. Chang MH, Kim KH, Kim HS, Jun HJ, Kim DH, Jang JH, et al. Predictors of response to immuno-suppressive therapy with antithymocyte globulin and cyclosporine and prognostic factors for survival in patients with severe aplastic anemia. Eur J Haematol 2010;84:154–159.

    Article  PubMed  CAS  Google Scholar 

  9. Hattori M, Terasawa T, Tsushita K, Utsumi M, Kawano F, Saito H, et al. The status of antithymocyte globulin therapy for adult patients in Japan: retrospective analysis of a nation wide survey. Int J Hematol 2008;87:48–55.

    Article  PubMed  Google Scholar 

  10. Scheinberg P, Wu CO, Nunez O, Young NS. Predicting response to immunosuppressive therapy and survival in severe aplastie anaemia. Br J Haematol 2009;144:206–216.

    Article  PubMed  CAS  Google Scholar 

  11. Führer M, Rampf U, Baumann I, Faldum A, Niemeyer C, Janka-Schaub G, et al. Immunosuppressive therapy for aplastic anemia in children: a more severe disease predicts better survival. Blood 2005;106:2102–2104.

    Article  PubMed  Google Scholar 

  12. Chen G, Kook H, Zeng W, Young NS, Maciejewski JP. Is there a direct effect of antithymocyte globulinon hematopoiesis? Hematol J 2004;5:255–261.

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Xu-dong Tang  (唐旭东), Feng Liu  (刘 锋), Liu Li  (李 柳), Chi Liu  (刘 驰), Shan-shan Zhang  (张姗姗), Hai-yan Xiao  (肖海燕), Chun-mei Zheng  (郑春梅), Shu Xu  (徐 述) & Rou Ma  (麻 柔)

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  1. Xu-dong Tang  (唐旭东)
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  2. Feng Liu  (刘 锋)
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  3. Liu Li  (李 柳)
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  4. Chi Liu  (刘 驰)
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  5. Shan-shan Zhang  (张姗姗)
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  6. Hai-yan Xiao  (肖海燕)
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  7. Chun-mei Zheng  (郑春梅)
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  8. Shu Xu  (徐 述)
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  9. Rou Ma  (麻 柔)
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Corresponding author

Correspondence to Feng Liu  (刘 锋).

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Tang, Xd., Liu, F., Li, L. et al. Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin. Chin. J. Integr. Med. 18, 40–45 (2012). https://doi.org/10.1007/s11655-011-0874-0

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  • DOI: https://doi.org/10.1007/s11655-011-0874-0

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