title: [Residual hematopoiesis is an important prognostic factor of immunosuppressive therapy in severe aplastic anemia].
abstract: OBJECTIVE
  To evaluate the prognostic value of residual bone marrow hematopoiesis in severe aplastic anemia (SAA) patients with immunosuppressive therapy (IST).
  
  
  METHODS
  Clinical data and hematologic responses of 38 SAA patients treated with IST regimen (antithymocyte globulin combined with cyclosporine) in our hospital were retrospectively analyzed. Correlation of pre-IST baseline reticulocyte (Ret), absolute neutrophils count (ANC), soluble transferrin receptor (sTfR) concentration, corrected TPO value and hematologic response rate were statistically analyzed and receiver operating characteristic (ROC) curve was used to estimate the value of Ret, ANC, sTfR, and corrected TPO in predicting early IST response.
  
  
  RESULTS
  Responders to IST had significantly higher pre-IST baseline Ret, ANC, sTfR concentration [19.9(2.7-84.4)×10⁹/L, 0.59(0.12-2.67)×10⁹/L, 0.82(0.22-1.58) mg/L] and lower corrected TPO value [142.9(31.8-1 035.0)] than non-responders [5.1(1.5-23.1)×10⁹/L, 0.20(0.04-1.33)×10⁹/L, 0.45(0.19-0.72)mg/L and 2 335.0(1 308.3-7 771.2)](P<0.05). Optimizing parameter cutoff levels obtained from ROC curve was Ret 6.75×109/L, ANC 0.30×109/L, sTfR 0.76 mg/L and corrected TPO 148.6, respectively. Combining the four parameters to predict 6 month hemotologic response showed that all the 7 patients with high Ret, ANC, sTfR and low corrected TPO, while only 1 among those 9 with low Ret, ANC, sTfR and high corrected TPO.
  
  
  CONCLUSIONS
  Such parameters evaluating residual bone marrow hematopoiesis as Ret, ANC, sTfR, corrected TPO are practical in predicting early IST response in SAA.
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: Zhijie
authors.initials: Z
authors.lastname: Wu
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: Liping
authors.initials: L
authors.lastname: Jing
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: Kang
authors.initials: K
authors.lastname: Zhou
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: Yang
authors.initials: Y
authors.lastname: Li
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: Fengkui
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000741:Anemia, Aplastic; D000961:Antilymphocyte Serum; D001853:Bone Marrow; D016572:Cyclosporine; D006410:Hematopoiesis; D006801:Humans; D007166:Immunosuppressive Agents; D007958:Leukocyte Count; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine