[A long-term follow-up study of 50 patients with severe aplastic anemia who have survived more than 3 years after immunosuppressive therapy].
OBJECTIVE
To evaluate the long-term outcome of immunosuppressive therapy (IST) in patients with severe aplastic anemia (SAA).


METHODS
Hematopoietic recovery (peripheral blood cell counts, bone marrow aspirates, bone marrow biopsy, in vitro culture of hematopoietic progenitors), immunity of T lymphocyte, quality of life and side-effects of the therapy were assessed in 50 SAA patients who have survived more than 3 years after IST.


RESULTS
At 3 years, 4 years and 5 years follow-up, 81.5% (13 cases), 86.7% (13 cases) and 89.5% (17 cases) of the SAA patients reached and maintained normal peripheral blood cell counts, 93.4% (15 cases), 93.3% (14 cases) and 94.7% (18 cases) showed normal bone marrow pictures, and 37.5% (6 cases), 40.0% (6 cases) and 73.7% (14 cases) had normal yields of bone marrow cell culture, respectively. Overall, 86.0% (43 cases), 94.0% (47 cases) and 52.0% (26 cases) of the total SAA patients were normalized in peripheral blood counts, bone marrow picture and culture of hematopoietic progenitor yields, respectively. During the follow-up, 88.0% (44 cases) of the patients achieved 100 of Karnofsky scores; 26 of the 31 patients (83.9%) who received bone marrow biopsy showed normal histological pictures, and 29 of 37 patients (78.4%) tested had normal subsets of T lymphocytes. No clonal disease was found. The late side-effects of IST were mild. All of the parameters tested were normal in 24 patients.


CONCLUSIONS
After IST, the hematopoietic function of bone marrow, the immunity of the T lymphocyte and the life quality were normalized with few side-effects in patients with SAA. These patients would probably be cured.
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China.
Guangsheng
G
He
Zonghong
Z
Shao
Hong
H
Liu
Yizhi
Y
Zhang
Guibin
G
Chen
Ke
K
Li
Luyan
L
Song
Hong
H
He
Migngfeng
M
Zhao
Rong
R
Fu
Jun
J
Shi
Jie
J
Bai
Hong
H
Zhang
Yulin
Y
Chu
Tianying
T
Yang
Chongli
C
Yang
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000401:mortality; D001772:Blood Cell Count; D001856:Bone Marrow Examination; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017567:Karnofsky Performance Status / Q000592:standards; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents