Prognostic factors of cyclosporine A combined with androgen in the treatment of transfusion dependent non-severe aplastic anemia.
- Author:
Chen Xi LIU
1
;
Lin SONG
1
;
Li ZHANG
1
;
Li Ping JING
1
;
Kang ZHOU
1
;
Xin ZHAO
1
;
Hui Hui FAN
1
;
Guang Xin PENG
1
;
Yang LI
1
;
Jian Ping LI
1
;
Yuan LI
1
;
Lei YE
1
;
Yang YANG
1
;
Wen Rui YANG
1
;
You Zhen XIONG
1
;
Qi SUN
1
;
Kun RU
1
;
Feng Kui ZHANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Androgen; Aplastic anemia; Cyclosporine A; Prognostic factors
- MeSH: Androgens/therapeutic use*; Anemia, Aplastic/drug therapy*; Antilymphocyte Serum; Cyclosporine/therapeutic use*; Drug Combinations; Humans; Immunosuppressive Agents; Prognosis; Retrospective Studies; Treatment Outcome
- From: Chinese Journal of Hematology 2020;41(3):234-238
- CountryChina
- Language:Chinese
- Abstract: Objective: To analyze the prognostic factors of transfusion-dependent non-severe aplastic anemia (TD-NSAA) patients treated with cyclosporine A (CsA) and androgen. Methods: Clinical data of 77 consecutive TD-NSAA patients treated with CsA and androgen were retrospectively analyzed between 2010 and 2013. We obtained clinical manifestations and baseline parameters of routine blood test from responders, and compared those with non-responders. All data were analyzed by univariate analysis and multivariate analysis. Results: In 77 patients, there were 43 (55.8%) patients achieved hematological response after 6 months'treatment, and 53 (68.8%) patients got response after 12 months. Univariate analysis showed that platelets baseline was the only factor related to hematological response [19 (6-61) ×10(9)/L vs 13.5 (5-45) ×10(9)/L, P=0.001] after 6 months therapy. After 12 months, the statistical differences were maintained, which were platelets baseline [18 (6-61) ×10(9)/L vs 10.5 (5-45) ×10(9)/L, P<0.001], absolute reticulocytes [0.03 (0.01-0.06) ×10(12)/L vs 0.029 (0.02-0.06) ×10(12)/L, P=0.043], transfusion-dependent of platelet (P=0.007) , transfusion-dependent of platelet and erythrocyte (P=0.012) . Multivariate analysis showed that platelets baseline could be an independent prognostic factor of hematological response (P=0.010 or 0.009) . Cutoff value of platelets by receiver operating characteristic curve was 15.5×10(9)/L. Conclusion: Baseline of higher platelets, higher reticulocyte, and no transfusion dependence of platelet are favorable prognostic factors. When platelets baseline is higher than 15.5×10(9)/L, CsA and androgen regimen is rational.
