title: [Combination of rabbit antithymocyte globulin and cyclosporine A as first-line therapy for adult severe aplastic anemia].
abstract: OBJECTIVE
  To analyze the efficacy and side-effects of combination of rabbit antithymocyte globulin (ATG) and cyclosporine A (CsA) as the first-line immunosuppressive therapy (IST) for adult severe aplastic anemia (SAA) patients.
  
  
  METHODS
  Adult SAA or very severe aplastic anemia (VSAA) patients treated with rabbit ATG + CsA as first line therapy in our hospital from 2003 to 2008 were retrospectively analysed and the therapeutic response relevant factors were analysed.
  
  
  RESULTS
  Seventy-nine patients were enrolled. Of all these patients, 6 died within 3 months after IST. The overall response rate was 82.2% and the median time to transfusion independent was 60 days. The therapeutic response rate in 32 SAA patients (100%) was significantly higher than that in 41 VSAA cases (68.3%) (P = 0.001). Patients with neutrophil response to G-CSF treatment had a higher IST response rate than those without response to G-CSF (100% vs 67.5%, P = 0.001). Sixty-one patients (77.2%) occurred serum sickness reaction. Three patients relapsed and two developed clonal hematological abnormalities after IST. The 3-year overall survival for all the patients was 88.9%.
  
  
  CONCLUSIONS
  Rabbit ATG in combination with CsA as first-line IST for adult SAA can lead to excellent treatment outcomes with minor adverse effects.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Cao
authors.forename: Hui-jun
authors.initials: HJ
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Jing
authors.forename: Kang
authors.initials: K
authors.lastname: Zhou
authors.forename: Dong-lin
authors.initials: DL
authors.lastname: Yang
authors.forename: Hong-qiang
authors.initials: HQ
authors.lastname: Li
authors.forename: Qing-guo
authors.initials: QG
authors.lastname: Liu
authors.forename: Zhang-song
authors.initials: ZS
authors.lastname: Yan
authors.forename: Yong-ze
authors.initials: YZ
authors.lastname: Liu
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Wu
authors.forename: Yu-Lin
authors.initials: YL
authors.lastname: Chu
authors.forename: Feng-kui
authors.initials: FK
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000188:drug therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine