|
|
|
| Effect of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia |
| XUE Lianguo MAO Jianping JIA Tao WANG Ying CHEN Ze CAI Zhimei▲ ZHAO Lidong |
| Department of Hematology, the First People′s Hospital of Lianyungang City, Jiangsu Province, Lianyungang 222002, China |
|
|
|
Abstract Objective To analyze the efficacy and safety of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia. Methods A total of 30 cases hospitalized in Department of Hematology, the First People′s Hospital of Lianyungang City, Jiangsu Province from Apirl 2004 and December 2016 were enrolled into this study. The efficacy and safety of this treatment were analyzed, the overall survival by Kaplan-Meier method for this cohort of patients were estimated. Results The cohort of 30 patients was routinely followed up with a median follow-up of 60 (1-252) months, the median age was 26.5 (5-65) years old. Six died, the over response rate was 73.3%. The median time of the ANC＞0.5×109/L was 20 (2-40) days, transfusion of red blood cell independent was 30 (0-150) day, transfusion of palete independent was 30 (0-150) days, the 5-year survival rate was 78%. The response rate was high, but with less side effects and expense. Conclusion Long-term effect of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia is significant, adverse reactions are mild, it is worthy of clinical promotion.
|
|
|
|
|
|
[1] 唐瑞梅，林丽娥，朱永，等.重组粒细胞集落刺激因子对再生障碍性贫血并感染患者免疫功能的影响[J].中国医药导报，2016，13（26）：60-63.
[2] 中华医学会血液学分会红细胞疾病（贫血）学组.再生障碍性贫血诊断治疗专家共识[J].中华血液学杂志，2010， 31（11）：790-792.
[3] 张之南，沈娣.血液病诊断及疗效标准[M].3版.北京：科学出版社，2007：19-23.
[4] Marsh JC，Ball SE，Cavenagh J，et al.Guidelines for the diagnosis and management of aplastic anaemia[J].Br J Haematol，2009，147（1）：43-70.
[5] Scheinberg P，Wu CO，Nunez O，et al. Treatment of severe aplastic anemia with a combination of horse antithymocyte globulin and cyclosporine，with or without sirolimus：a prospective randomized study [J]. Haematologica，2009，94（3）：348-354.
[6] Atta EH，Dias DS，Marra VL，et al. Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia：a single-center retrospective study [J]. Ann Hematol，2010，89（9）：851-859.
[7] 蔡炜琳，王薇娜，张田.环孢素A联合康力龙、益血生治疗再生障碍性贫血的疗效观察[J].中国医药导报，2009， 6（27）：56-57.
[8] 陈艳丽，程志，韦润红，等.中西医结合治疗重型再生障碍性贫血26例[J].中国医药导报，2009，6（33）：74-75.
[9] 黄建清，任碧连.小剂量环孢素联合达那唑治疗慢性再生障碍性贫血的效果评价[J].中国当代医药，2016，23（19）：156-158.
[10] 谢晓恬.《2009年版英国再生障碍性贫血诊断与治疗指南》要点归纳[J].中华实用儿科临床杂志，2014，29（3）：161-164.
[11] 何广胜，邵宗鸿，张益枝，等.序贯强化免疫抑制并用造血生长因子治疗重型再生障碍性贫血[J].中华血液学杂志，2001，22（4）：176-181.
[12] 何广胜，邵宗鸿，刘鸿，等.50例存活三年以上重型再生障碍性贫血患者的长期随访[J].中华血液学杂志，2002， 23（5）：229-232.
[13] 展世宏，卢俊，李建琴，等.抗淋巴细胞球蛋白为主的免疫抑制剂治疗重型再生障碍性贫血疗效分析[J].中国小儿血液与肿瘤杂志，2011，16（1）：15-19.
[14] Bacigalupo A，Bruno B，Saracco P，et al. Antilymphocyte globulin，cyclosporine，prednisolone，and granulocyte colo?鄄 ny-stimulating factor for severe aplastic anemia：an update of the GITMO/EBMT study on 100 patients. European Group for Blood and Marrow Transplantation（EBMT） Working Party on Severe Aplastic Anemia and the Gruppo Italiano Trapianti di Midolio Osseo（GITMO） [J]. Blood，2000，95（6）：1931-1934.
[15] Frickhofen N，Kaltwasser JP，Schrezenmeier H，et al. Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. The German Aplastic Anemia Study Group [J]. N Engl J Med，1991， 324（19）：1297-1304.
[16] Kojima S，Hibi S，Kosaka Y，et al. Immunosuppressive therapy using antithymocyte globulin，cyclosporine，and danazol with or without human granulocyte colony-stimulating factor in children with acquired aplastic anemia [J]. Blood，2000， 96（6）：2049-2054.
[17] Rosenfeld SJ，Kimball J，Vining D，et al. Intensive immunosuppression with antithymocyte globulin and cyclosporine as treatment for severe acquired aplastic anemia [J]. Blood，1995，85（11）：3058-3065.
[18] 梁冬梅，聂大年，尹松梅，等.强化免疫抑制治疗重型再生障碍性贫血18例[J].实用医学杂志，2006，22（23）：2763-2764.
[19] 曹慧敏，王慧君，张莉，等.一线应用兔源抗胸腺细胞球蛋白联合环孢素治疗成人重型再生障碍性贫血疗效分析[J].中华血液学杂志，2011，32（1）：38-42.
[20] 张兴霞，刘立民，赵广圣，等.猪抗人淋巴细胞球蛋白联合环孢素治疗重型再生障碍性贫血患者22例[J].中华血液学杂志，2014，35（5）：451-453.
[21] Chen M，Liu C，Zhuang JL，et al. Long-term follow-up study of porcine anti-human thymocyte immunoglobulin therapy combined with cyclosporine for severe aplastic anemia [J]. Eur J Haematol，2015，96：291-296.
[22] Wei J，Huang Z，Guo J，et al. Porcine antilymphocyte globulin（P-ALG）plus cyclosporine A（CsA）treatment in acquired severe aplastic anemia：a retrospective multicenter analysis [J]. Ann Hematol，2015，94（6）：955-962． |
|
|
|
