title: [Increasing peripheral blood neutrophils after G-CSF treatment is a predictor of early response to immunosuppressive therapy in severe aplastic anemia].
abstract: OBJECTIVE
  To testify whether absolute neutrophil count (ANC) response to preimmunosuppressive-therapy (pre-IST) granulocyte-stimulating factor (G-CSF) treatment could predict early response to IST in severe aplastic anemia (SAA).
  
  
  METHODS
  Clinical data and hematologic response of 125 SAA patients treated with antithymocyte globulin (r-ATG) combined with cyclosporine were retrospectively analyzed. Correlation of ANC response to pre-IST G-CSF treatment and early response to IST were statistically analyzed, and receiver operating characteristic (ROC) curve was used to estimate the value of increased ANC (∆ANC) in predicting early IST response.
  
  
  RESULTS
  The hematologic response (HR) rate to IST in ANC reponded patients was significantly higher than non-responded group (3-month HR 49.0% vs 28.9%, P=0.023; 6-month HR 61.2% vs 40.8%, P=0.026). With ∆ANC≥0.5×10⁹/L as cutoff level, the best point to predict early IST response was 10 days after G-CSF (d 10). Response of ANC to pre-IST G-CSF treatment at d 10 was among the independent factors of predicting 3-month (P=0.004), but not for 6-month response to IST. The overall 5-year survival rate was 92.8% and 69.5% in ANC responded and non-responed groups, respectively (P=0.025).
  
  
  CONCLUSIONS
  Responding to pre-IST G-CSF treatment reflected the residual bone marrow hematopoiesis, and could act as a convenient and practical predictor to early IST response as well as long-term survival in SAA.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Wenrui
authors.initials: W
authors.lastname: Yang
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Jing
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Guangxin
authors.initials: G
authors.lastname: Peng
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Huihui
authors.initials: H
authors.lastname: Fan
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Song
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin　300020, China.
authors.forename: Fengkui
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000741:Anemia, Aplastic / Q000188:drug therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009504:Neutrophils / Q000187:drug effects*
chemical_list: D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor