title: [Effects of concentration of cyclosporine A on the early response to immunosuppressive therapy in severe aplastic anemia].
abstract: OBJECTIVE
  To evaluate the effects of cyclosporine A (CsA) whole-blood concentration on the early response to immunosuppressive therapy (IST) in severe and very severe aplastic anemia (SAA/VSAA).
  
  
  METHODS
  Ninety SAA/VSAA patients treated with rabbit antithymocyte globulin (ATG) plus CsA as first line therapy in our hospital were retrospectively analysed. CsA levels between the response group and non-response group, and response rates of patients with variant CsA levels were compared respectively.
  
  
  RESULTS
  (1) There was no significant difference in the beginning unmodified CsA blood concentration between IST responded and non-responded SAA/VSAA patients. The beginning unmodified C(0) 133.91 ug/L in IST 2-month responders was higher than that of 49.9 ug/L in non-responded SAA patients (P = 0.009); (2) The mean CsA C(0) and C(2) levels during the third month following IST were significantly different in responders and non-responders(197.52 µg/L vs 161.49 µg/L, P = 0.024, and 738.76 µg/L vs 615.46 µg/L, P = 0.009), and no significant difference in other periods of IST (P > 0.05); (3) The response rate (87.5%) was significantly higher in patients with CsA C(0) ≥ 200µg/L the third month following IST than those of 55.6% in patients with CsA C(0) 150 - 200 µg/L (P = 0.023) and 59.3% in patients with CsA C(0) < 150 µg/L (P = 0.046), respectively. The response rate was significantly higher of C(2) ≥ 700 µg/L group than that of C(2) < 700 µg/L group (80.5%vs 55.3%, P = 0.012).
  
  
  CONCLUSIONS
  The CsA concentration related to the early IST response. The third month CsA concentrations was the most important for the response and maintaining CsA levels with C(0) ≥ 200 µg/L and C(2) ≥ 700 µg/L may improve the response to IST in SAA/VSAA.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, Tianjin, China.
authors.forename: Li-yan
authors.initials: LY
authors.lastname: Liang
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: Xiao-dan
authors.initials: XD
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Guang-xin
authors.initials: GX
authors.lastname: Peng
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Li
authors.forename: Li-Hui
authors.initials: LH
authors.lastname: Shi
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.forename: Hui-hui
authors.initials: HH
authors.lastname: Fan
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
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 / Q000097:blood* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000097:blood*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine