Porcine antilymphocyte globulin (p-ALG) plus cyclosporine A (CsA) treatment in acquired severe aplastic anemia: a retrospective multicenter analysis

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• 作者：Jia Wei ; Zhiping Huang ; Jingming Guo ; Youshan Zhang ; Chunyan Wang…
• 关键词：Severe aplastic anemia ; Porcine ALG ; Overall response ; Overall survival
• 刊名：Annals of Hematology
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：94
• 期：6
• 页码：955-962
• 全文大小：445 KB
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  20.Rosenfeld SJ
• 作者单位：Jia Wei (1)
  Zhiping Huang (2)
  Jingming Guo (3)
  Youshan Zhang (4)
  Chunyan Wang (1)
  Xianmin Zhu (1)
  Yicheng Zhang (1)
  
  1. Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-Fang Avenue, 430030, Wuhan, China
  2. Department of Hematology, Jingzhou Central Hospital, 434020, Jingzhou, China
  3. Department of Hematology, Yichang Central People’s Hospital, China Three Gorges University, 443003, Yichang, China
  4. Department of Hematology, the First People’s Hospital of Jingzhou, Yangtze University, 434000, Jingzhou, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

Severe aplastic anemia (SAA) is a life-threatening bone marrow failure syndrome characterized by pancytopenia and hypocellular bone marrow. Antithymocyte globulin (ATG) is the drug of choice for immunosuppressive therapy (IST) in patients with SAA ineligible for allogeneic stem cell transplantation. This study aimed to evaluate the efficacy and safety profile of porcine antilymphocyte globulin (p-ALG) plus CsA in the treatment of acquired SAA. Clinical information of 69 SAA patients treated with p-ALG plus CsA was collected and retrospectively analyzed for early mortality, response rate, survival rate, side effects, and other complications. The median age at diagnosis was 27?years (range 14 to 52). The overall response rate was 76.8?% with a 90-day median response time (range 30?~-60?days). Overall response rates at 3, 6, 12, 18, and 24?months were 63.8, 73.9, 76.8, 75.4, and 75.4?%, respectively. The median follow-up time for surviving patients was 24?months (range 4?~-4?months) and the 2-year overall survival (OS) rate was 88.4?%. The disease-free survival (DFS) rate at 2?years was 85.5?%. Older age (?5?years), very (v)SAA subgroup, and lower baseline absolute lymphocyte count (<1?×-09/L) were independent unfavorable predictors of overall survival (p-lt;-.05). Less than one third of patients had serum sickness or allergic reaction during ALG therapy, but symptoms could easily be relieved by steroid treatment; 27.54?% had mild hepatic impairment. Taken together, p-ALG showed similar efficacy and safety profiles to rabbit or horse ATG in IST of acquired SAA. It can be a suitable alternative preparation for rabbit ATG with the great advantage of lower medical expenses.