title: [Antithymocyte/Antilymphocyte globulin plus cyclosporine A therapy for the treatment of older patients with severe aplastic anemia].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intensive immunosupressive therapy (IST) with antithymocyte/antilymphocyte globulin plus cyclosporine A in the treatment of older patients (≥60 years) with severe aplastic anemia (SAA).
  
  
  METHODS
  The hematologic response and safety of sixteen older SAA patients treated with IST regimen in our hospital were retrospectively analyzed , and the factors affecting response were also explored.
  
  
  RESULTS
  A total of 16 older SAA patients were involved, the median age was 63.5 (60-79) years. Among them, 7 were VSAA and 9 were SAA; 9 patients received Rabbit anti- human thymocyte globulin (rATG), and 7 patients porcine anti- human lymphocyte globulin (pALG). Two patients died within 3 months after IST; at the 6 months after IST, 9 patients achieved hematology response and 5 patients had no response; overall response rate was 56.3%. Two (22%) of the 9 patients treated with rATG achieved hematology response; However, all 7 patients (100.0%) treated with pALG achieved hematology response. rATG/pALG associated adverse reactions were mild and easily managed.
  
  
  CONCLUSIONS
  The older patients with SAA could still benefit from IST consisting of standard dose rATG/pALG with CsA, and the patients with VSAA had worse prognosis, pALG was inferior to rATG as a first treatment for SAA.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: J P
authors.initials: JP
authors.lastname: Li
authors.forename: W R
authors.initials: WR
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Ye
authors.forename: K
authors.initials: K
authors.lastname: Zhou
authors.forename: L P
authors.initials: LP
authors.lastname: Jing
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: G X
authors.initials: GX
authors.lastname: Peng
authors.forename: L
authors.initials: L
authors.lastname: Song
authors.forename: F K
authors.initials: FK
authors.lastname: Zhang
authors.forename: L
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000741:Anemia, Aplastic / Q000628:therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D006801:Humans; D011817:Rabbits; D012189:Retrospective Studies; D013552:Swine; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D016572:Cyclosporine