title: Immunosuppressive therapy in aplastic anemia.
abstract: OBJECTIVE
  To assess the response to antithymocyte globulin based immunosuppressive therapy (IST) in pediatric patients with idiopathic aplastic anemia.
  
  
  METHODS
  Thirty patients (19 boys and 11 girls) with aplastic anemia received antithymocyte globulin and cyclosporine. Twenty-two patients had severe and 8 had very severe aplastic anemia.
  
  
  RESULTS
  Mean age of the patients was 9.19 ± 2.56 y. Three patients died within 1 mo of therapy, two due to sepsis and one due to intracranial hemorrhage. Twenty-seven patients were analyzed for response to therapy. Eight patients (29.7%) responded at 3 mo: 3 complete response (CR) and 5 partial response (PR). Six mo after the therapy, overall response (OR) was seen in 9/27 (33.3%), with one more patient in no response group achieving partial response. At 1 year, patients in CR maintained their status and 1 patient in PR group relapsed. He again achieved partial response with repeat course of ATG. Responders had significantly shorter duration of illness and higher absolute neutrophil count as compared to non responders to IST. None of the patients developed acute leukemia in the follow up.
  
  
  CONCLUSIONS
  The treatment of aplastic anemia in pediatric patients is a challenging task. One third of the patients achieved overall response which included both complete and partial response.
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. vineetaguptabhu@gmail.com
authors.forename: Vineeta
authors.initials: V
authors.lastname: Gupta
authors.forename: Akash
authors.initials: A
authors.lastname: Kumar
authors.forename: Vijai
authors.initials: V
authors.lastname: Tilak
authors.forename: Isha
authors.initials: I
authors.lastname: Saini
authors.forename: Baldev
authors.initials: B
authors.lastname: Bhatia
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D012189:Retrospective Studies; D012698:Serologic Tests; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine