[Therapeutic effects of a combination of high-dose immunoglobulin and cyclosporine A in children with aplastic anemia].
OBJECTIVE
To evaluate the therapeutic effects of a combined immunotherapy, high-dose immunoglobulin (HDIG) plus cyclosporine A (CsA) plus prednisone (P), in children with aplastic anemia (AA) and to explore the association of peripheral blood lymphocyte subsets, peripheral blood cells and marrow CD34+ cells with therapeutic effects in AA.


METHODS
The clinical data of 46 children with AA and who received the combined immunotherapy of HDIG + CsA + P were retrospectively studied.


RESULTS
Of the 46 children with AA, 31 (67.4%) were responded to the combined immunotherapy. The binary logistic regression analysis showed low absolute neutrophil count (B=4.703, p<0.05), low percentage of peripheral blood CD4+ cells (B=0.142, p<0.05) and low ratio of peripheral blood CD4+/CD8+ (B=2.945, p<0.05)were associated with poor therapeutic effects. The ratio of CD34+/karyocytes of bone marrow in children with AA was lower than that in normal individuals, but it was not significantly related to the therapeutic effect.


CONCLUSIONS
The combined immunotherapy (HDIG+CsA+P) was effective in children with AA. The absolute neutrophilcount, the percentage of peripheral blood CD4+ and the ratio of peripheral blood CD4+/CD8+ were important prognostic factors in AA.
Qiu
Yi-Ning
YN
Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan 430022, China.
Bai
Yan
Y
Yu
Hui
H
Zhou
Dong-Feng
DF
Zhang
Zhi-Quan
ZQ
Xiao
Yan
Y
Jin
Run-Ming
RM
D000293:Adolescent; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000276:immunology; D016516:CD4-CD8 Ratio; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007223:Infant; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies
D007136:Immunoglobulins; D016572:Cyclosporine