Immunomodulation Therapy in Aplastic Anemia : Relapse Rate, Complications and Long-term Survival During Follow-up for More than 1 Year
Year: 1998
Type: article
Abstract: Purpose : We evaluated the response to immunomodulation therapy, long-term survival and relapse rate of aplastic anemia during follow-up for more than 1 year. Methods : Twenty-eight children, with moderate to severe aplastic anemia were followed for more than one year and 7 children expired after therapy, were analyzed. Antilymphocyte globulin(ALG) or antithymocyte globulin(ATG) by itself was given to 27 patients, and cyclosporine A(CsA) combined with ALG was given to 8 patients. ALG(ATG) was administered for 8 days in 20mg/kg/day when used alone, and for 5 days in 10mg/kg/day when combined with CsA. CsA was orally administered on the 14th day till 180th day of therapy, with 5mg/kg/day for first 14 days and 3mg/kg/day thereafter. Results : Fifteen out of 35 patients(43%) showed a response. Median interval to response was 3 month(1-40 months). Response rate to ALG＋CsA was 50%, compared to 41% in ALG(or ATG) alone. The interval of aplastic anemia symptoms to treatment showed a tendency to be shorter in responders(4.1±2.2 months) than in non-responders(17.5±6.4 months). Relapse occurred in 3 of 15 responders(20%). Evolution to secondary clonal hematologic disorders was not observed. Overall actuarial survival at 3 year was 78.2% Conclusion : The results of immunomodulation therapy suggest that response would be better for patients whose interval from symptoms of aplastic anemia to treatment is short. Our results also suggest that ALG＋CsA would be a better treatment modality to improve response rate. (J Korean Pediatr Soc 1998;41:775-784)
Source: Korean Journal of Pediatrics
Institution: Seoul National University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2276099755