Authors: Jia Wei Zhiping Huang Jingming Guo Youshan Zhang Chunyan Wang Xianmin Zhu Yicheng Zhang
Publish Date: 2015/02/11
Volume: 94, Issue: 6, Pages: 955-962
Abstract
Severe aplastic anemia SAA is a lifethreatening 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 pALG plus CsA in the treatment of acquired SAA Clinical information of 69 SAA patients treated with pALG 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 768 with a 90day median response time range 30 ~ 360 days Overall response rates at 3 6 12 18 and 24 months were 638 739 768 754 and 754 respectively The median followup time for surviving patients was 24 months range 4 ~ 44 months and the 2year overall survival OS rate was 884 The diseasefree survival DFS rate at 2 years was 855 Older age ≥45 years very vSAA subgroup and lower baseline absolute lymphocyte count 1 × 109/L were independent unfavorable predictors of overall survival p 005 Less than one third of patients had serum sickness or allergic reaction during ALG therapy but symptoms could easily be relieved by steroid treatment 2754 had mild hepatic impairment Taken together pALG 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
Keywords: