title: [Treatment of transfusion-dependent nonsevere aplastic anemia with cyclosporine A plus ATG/ALG versus cyclosporine A plus androgens: a retrospective single center study].
abstract: Objective:To determine whether cyclosporine A (CsA) plus androgens was as effective as the current standard immunosuppressive therapy (IST) for transfusion-dependent nonsevere aplastic anemia (TD-NSAA).Methods:The records of 125 consecutive TD-NSAA patients who were treated between Aug. 2007 and Sept. 2014, with either CsA plus androgen or ALG/ATG plus CsA regimen were reviewed. The 3-month and 6-month hematologic responses and survival were evaluated.Results:There were 125 TD-NSAA patients (70 were male and 55 female, 1.25∶1). Median age was 27 (6-66) years. There was no significant difference in early mortality between 48 treated by ATG/ALG plus CsA and 77 by CsA plus androgen patients (1/48vs0/77,P=0.384). Both the total hematologic response and the better hematological response rates at 3-month (70.8%vs45.5%,P=0.006 and 27.1%vs10.4%,P=0.015, respectively) and 6-month (75.0%vs55.8%,P=0.031 and 41.7%vs22.1%P=0.020, respectively) after treatment were much higher in the standard IST group than that in CsA plus androgen group. The median time to transfusion independent of 36.5 (0-149) days in the standard IST group was significantly shorter than 98 (14-180) days in CsA plus androgen group (P<0.001). Survival was comparable between the two groups (97.9%vs100.0%,P=0.227). It was superior (71.2%vs59.5%) but not significantly (P=0.227) in event-free survival in standard IST group.Conclusions:CsA plus androgen was inferior to the standard IST of ATG/ALG and CsA regimen in treating TD-NSAA in terms of the hematologic response and the quality of response, despite of comparable short-term survival.
authors.affiliation: Institute of Hematology and Blood Disease Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: L
authors.initials: L
authors.lastname: Song
authors.forename: G X
authors.initials: GX
authors.lastname: Peng
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Wu
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: L P
authors.initials: LP
authors.lastname: Jing
authors.forename: K
authors.initials: K
authors.lastname: Zhou
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Ye
authors.forename: J P
authors.initials: JP
authors.lastname: Li
authors.forename: H H
authors.initials: HH
authors.lastname: Fan
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.forename: W R
authors.initials: WR
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: F K
authors.initials: FK
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000728:Androgens / Q000627:therapeutic use*; D000741:Anemia, Aplastic / Q000188:drug therapy*; D000961:Antilymphocyte Serum; D001803:Blood Transfusion; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000728:Androgens; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine