Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin

Xu-dong Tang; Feng Liu; Liu Li; Chi Liu; Shan-shan Zhang; Hai-yan Xiao; Chun-mei Zheng; Shu Xu; Rou Ma

doi:10.1007/s11655-011-0874-0

Your Location：

Home >

Browse articles >

Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin

OriginalPaper | Updated：2021-08-27

- Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin
- Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin
- 中国结合医学杂志（英文版） 2012年18卷第1期页码：40-45
- Affiliations：
  
  Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences,Beijing,China
- Author bio：
- Funds：
- DOI：10.1007/s11655-011-0874-0
  中图分类号：
- 纸质出版日期：2012，
  
  网络出版日期：2011-12-8，
Scan for full text
Tang, Xd., Liu, F., Li, L. et al. Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin., Chin. J. Integr. Med. 18, 40–45 (2012). https://doi.org/10.1007/s11655-011-0874-0

Xu-dong Tang, Feng Liu, Liu Li, et al. Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin[J]. Chinese Journal of Integrative Medicine, 2012,18(1):40-45.
Tang, Xd., Liu, F., Li, L. et al. Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin., Chin. J. Integr. Med. 18, 40–45 (2012). https://doi.org/10.1007/s11655-011-0874-0 DOI：

Xu-dong Tang, Feng Liu, Liu Li, et al. Analysis of the prognostic factors of very severe aplastic anemia treated with Chinese Kidney-invigorating drugs in combination with anti-lymphocyte globulin or anti-thymocyte globulin[J]. Chinese Journal of Integrative Medicine, 2012,18(1):40-45. DOI： 10.1007/s11655-011-0874-0.

摘要

To explore the prognostic factors for very severe aplastic anemia (VSAA) patients treated mainly with Chinese Kidney (Shen)-invigorating drugs (CKID) combined with anti-lymphocyte globulin (ALG) or anti-thymocyte globulin (ATG). Twenty-seven VSAA patients were treated with CSID+ALG/ATG therapy in conjunction with cyclosporine A

androgen

hemopoietic growth factor

etc. The relationship of the effectiveness and some factors (age of patients

course of illness

blood and bone marrow figures

etc.) were analyzed. In the 25 evaluated VSAA patients who had been followed up for over 1 year

9 patients (36.0%) were basically cured

5 (20.0%) remitted

6 (24.0%) were markedly improved

and 5 (20.0%) were treated in vain

with the total effective rate of treatment being 80.0% (20/25). Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA

of male sex (P=0.037)

>20 years old (P=0.045)

with an illness course ⩽ month (P=0.048)

with peripheral neutrophil count >0.1 × 109/L (P=0.023)

and with reticulocyte count >10 × 109/L (P=0.002). Platelet count (P=0.620) and bone marrow lymphocyte percentage (P=0.736) showed no correlation with the therapeutic effectiveness. Multi-factor analysis by the Kaplan-Meier procedure on the factors influencing survival showed that rather longer survival times occurred in patients > 20 years old

with peripheral neutrophil count ⩽ 0.1 × 109/L

reticulocyte count ⩽10 × 109/L

and platelet count > 10 × 109/L (all P=0.0001). Bone marrow lymphocyte percentage and the initiation time of ALG/ATG application (from onset of the illness) showed no significant influence on patients’ survival time (P=0.085 and P=0.935

respectively). CSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients’ survival rate. Conditions including male sex

age >20 years

illness course ⩽1 month

neutrophil count >0.1 × 109/L

and reticulocyte count >10 × 109/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.

Abstract

androgen

hemopoietic growth factor

etc. The relationship of the effectiveness and some factors (age of patients

course of illness

blood and bone marrow figures

etc.) were analyzed. In the 25 evaluated VSAA patients who had been followed up for over 1 year

9 patients (36.0%) were basically cured

5 (20.0%) remitted

6 (24.0%) were markedly improved

and 5 (20.0%) were treated in vain

with the total effective rate of treatment being 80.0% (20/25). Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA

of male sex (P=0.037)

>20 years old (P=0.045)

with an illness course ⩽ month (P=0.048)

with peripheral neutrophil count >0.1 × 109/L (P=0.023)

with peripheral neutrophil count ⩽ 0.1 × 109/L

reticulocyte count ⩽10 × 109/L

respectively). CSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients’ survival rate. Conditions including male sex

age >20 years

illness course ⩽1 month

neutrophil count >0.1 × 109/L

and reticulocyte count >10 × 109/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.

关键词

acute aplastic anemiavery severe aplastic anemiaChinese Kidney-invigorating drugsanti-antilymphocyte globulinanti-thymocyte globulin

Keywords

acute aplastic anemiavery severe aplastic anemiaChinese Kidney-invigorating drugsanti-antilymphocyte globulinanti-thymocyte globulin

references

Tang XD, Zhang SS, Ma R, Xu YG, Yang XH, Xiao HY, et al. Preliminary study on predictors for selection of immunosuppressive therapy or androgens in treating aplastic anemia patients. Chin J Integr Tradit West Med (Chin) 2009;29:106–110.

Zhang ZN, Shen D, eds, Diagnosis and treatment standards for blood diseases. 3rd ed. Beijing: Science Press; 2007:19–23.

Summary of the Fourth National Conference on Aplastic Anemia by Chinese Society of Hematology, Chinese Medical Association. The efficacy and diagnostic criteria for aplastic anemia. Chin J Hematol (Chin) 1987;8:486.

Young NS. Pathophysiologic mechanisms in acquired aplastic anemia. Hematology Am Soc Hematol Educ Program 2006:72–77.

Frickhofen N, Heimpel H, Kaltwasser JP, Schrezenmeier H, German Aplastic Anemia Study Group. Antithymocyte globulin with or without cyclosporin A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia. Blood 2003;101:1236–1242.

Rosenfeld S, Follmann D, Nunez O, Young NS. Antithymocyte globulin and cyclosporine for severe aplastic anemia: association between hematologic response and long-term outcome. JAMA 2003;289:1130–1135.

Locasciulli A, Oneto R, Bacigalupo A, Socié G, Korthof E, Bekassy A, et al. Outcome of patients with acquired apalstic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the Europen Group for Blood and Marrow Transplantation (EBMT). Haematogica 2007;92:11–18.

Chang MH, Kim KH, Kim HS, Jun HJ, Kim DH, Jang JH, et al. Predictors of response to immuno-suppressive therapy with antithymocyte globulin and cyclosporine and prognostic factors for survival in patients with severe aplastic anemia. Eur J Haematol 2010;84:154–159.

Hattori M, Terasawa T, Tsushita K, Utsumi M, Kawano F, Saito H, et al. The status of antithymocyte globulin therapy for adult patients in Japan: retrospective analysis of a nation wide survey. Int J Hematol 2008;87:48–55.

Scheinberg P, Wu CO, Nunez O, Young NS. Predicting response to immunosuppressive therapy and survival in severe aplastie anaemia. Br J Haematol 2009;144:206–216.

Führer M, Rampf U, Baumann I, Faldum A, Niemeyer C, Janka-Schaub G, et al. Immunosuppressive therapy for aplastic anemia in children: a more severe disease predicts better survival. Blood 2005;106:2102–2104.

Chen G, Kook H, Zeng W, Young NS, Maciejewski JP. Is there a direct effect of antithymocyte globulinon hematopoiesis? Hematol J 2004;5:255–261.

FULL TEXT LINK

More>

浏览量

116

Downloads

CSCD

文章被引用时，请邮件提醒。

Submit

工具集

关联资源

暂无数据