title: High-dose cyclophosphamide compared with antithymocyte globulin for treatment of acquired severe aplastic anemia.
abstract: A modified regimen of high-dose cyclophosphamide (CTX) plus cyclosporine (CsA) was adopted for patients with severe or very severe aplastic anemia, and the effectiveness was compared with a regimen of antithymocyte globulin (ATG) plus CsA. A total of 121 patients enrolled in this study received either CTX plus CsA (CTX group, 48 cases) or ATG plus CsA (ATG group, 73 cases). The early death rate was 4.2% in the CTX group and 8.2% in the ATG group, showing no significant difference (p = 0.312). The total response rate in the CTX and ATG groups was 54.2% and 57.5% at 3 months, 64.6% and 72.6% at 6 months, and 72.9% and 78.1% at 12 months, respectively (p > 0.05). The overall 5-year survival rate was 81.2% and 80.7%, and the event-free survival rate was 68.2% and 67.3% in the CTX and ATG groups, respectively (p > 0.05). The total medical cost of the CTX group was 54.8% less than that of ATG regimen (p = 0.000). In summary, treatment of severe or very severe aplastic anemia with CTX plus CsA has effectiveness that is comparable to a conventional regimen and less costly.
authors: Department of Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. ZhFK@Hotmail.com
authors: Fengkui
authors: F
authors: Zhang
authors: Li
authors: L
authors: Zhang
authors: Liping
authors: L
authors: Jing
authors: Kang
authors: K
authors: Zhou
authors: Huijun
authors: H
authors: Wang
authors: Guangxin
authors: G
authors: Peng
authors: Yang
authors: Y
authors: Li
authors: Yuan
authors: Y
authors: Li
authors: Jianping
authors: J
authors: Li
authors: Lei
authors: L
authors: Ye
authors: Lihui
authors: L
authors: Shi
authors: Huihui
authors: H
authors: Fan
authors: Xin
authors: X
authors: Zhao
authors: Yulin
authors: Y
authors: Chu
authors: Yushu
authors: Y
authors: Hao
authors: Jianxiang
authors: J
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000139:chemically induced; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use*; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000139:chemically induced; D017048:Health Care Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D017063:Outcome Assessment, Health Care / Q000191:economics; D012074:Remission Induction; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide