title: [Efficacy of immunosuppressive therapy for children with aplastic anemia].
abstract: OBJECTIVE
  To study the effectiveness and safety of immunosuppressive therapy (IST) in the treatment of childhood aplastic anemia (AA) and to study the main factors influencing the effectiveness.
  
  
  METHODS
  The clinical data of 55 children with severe aplastic anemia (SAA) and 51 children with chronic aplastic anemia (CAA) were retrospectively analyzed. All patients received IST from January 2007 to December 2010.
  
  
  RESULTS
  In children with CAA, the effective rate of antithymocyte globulin (ATG) plus cyclosporine A(CsA) combination therapy was significantly higher than that of CsA alone (80% vs 44%; P<0.05); in children with SAA, the effective rate of ATG plus CsA combination therapy was also significantly higher than that of CsA alone (75% vs 40%; P<0.05). No patients developed clonal disease such as myelodysplastic syndrome, paroxysmal nocturn hemoglobinuria or acute myelocytic leukemia. In patients treated with the ATG plus CsA combination therapy, the response rate was relatively high for children whose disease course was less than six months, bone marrow hematopoietic area was more than 40%, had no severe infections, and experienced granulocyte colony stimulating factor (G-CSF) reaction during the early treatment; however, it was not related to AA subtypes and age.
  
  
  CONCLUSIONS
  ATG plus CsA combination therapy is effective and safe in the treatment of childhood AA. The disease course, bone marrow hematopoietic area, severe infections and G-CSF reaction to early treatment are the main factors influencing the therapeutic effects.
authors.affiliation: Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. yingchaowang152@163.com
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Wang
authors.forename: Chu-Yun
authors.initials: CY
authors.lastname: Yin
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.forename: Chun-Mei
authors.initials: CM
authors.lastname: Wang
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Ma
authors.forename: Yong-Wei
authors.initials: YW
authors.lastname: Wei
authors.forename: Guang-Yao
authors.initials: GY
authors.lastname: Sheng
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000188:drug therapy*; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine