[Prognostic factors of immunosuppressive therapy in children acquired aplastic anemia].
OBJECTIVE
To investigate prognostic factors of immunosuppressive therapy (IST) in children acquired severe aplastic anemia(SAA).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Wang
Shu-chun
SC
Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Chen
Xiao-juan
XJ
Zou
Yao
Y
Yang
Wen-yu
WY
Liu
Tian-feng
TF
Zhang
Li
L
Chen
Yu-mei
YM
Guo
Ye
Y
Zhu
Xiao-fan
XF
D000293:Adolescent; D000741:Anemia, Aplastic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D011379:Prognosis; D011817:Rabbits; D012189:Retrospective Studies; D016896:Treatment Outcome
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine