Efficacy of Low Dose Combined Chemotherapy for Patients with Relapsed and Refractory Aplastic Anemia-Paroxysmal Nocturnal Hemoglobinuria Syndrome.
10.19746/j.cnki.issn.1009-2137.2019.04.036
- Author:
Ying LIN
1
;
Rong-Dong ZHANG
1
;
Ren-Li CHEN
2
Author Information
1. Department of Hematology, Ningde Hospital Affiliated to Fujian Medical University, Ningde 352100, Fujian Province, China.
2. Department of Hematology, Ningde Hospital Affiliated to Fujian Medical University, Ningde 352100, Fujian Province, China,E-mail: linying806@126.com.
- Publication Type:Journal Article
- MeSH:
Anemia, Aplastic;
Anemia, Refractory;
Hemoglobinuria, Paroxysmal;
Hemolysis;
Humans;
Retrospective Studies
- From:
Journal of Experimental Hematology
2019;27(4):1215-1219
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the clinical efficacy of low dose combined chemotherapy（LDCC） for patients with relapsed and refractory aplastic anemia-paroxysmal nocturnal hemoglobinuria（AA-PNH） syndrome, and to analyze the advantages of LDCC in the treatment of AA-PNH syndrome.
METHODS:The clinical characteristics and the curative effect of LDCC in 9 patients with relapsed and refractory AA-PNH syndrome were retrospectively analyzed. Five patients were treated with MP therapy［melphalan 2 mg/(m·d); prednisone 0.5 mg/(kg·d)］, and the other 4 patients were treated with HA therapy(HHT 2 mg/d iv drip, for 5 days; Ara-C 100 mg/d iv drip, for 5 days). The changes of PNH clone, dosage of corticosteroid, hemolysis and the relapse of disease, hematological parameters and adverse reactions were compared before and after therapy. All patients were treated for 1-2 courses.
RESULTS:Seven out of 9 patients responded well, the dosage of corticosteroid and the bilirubin concentration decreased significantly and anemia was relieved in 7 patients (P<0.05). One patient relapsed in one year. PNH clone of 3 patients turned negative. Five patients did not rely on blood transfusion in 1 year. There was no bone marrow failure to be found in all patients.
CONCLUSION:The LDCC has better efficacy and safety in the treatment of patients with AA-PNH syndrome, moreover, the patients is more tolerant to LDCC, thus the LDCC may be a selection for treatment of patients with relapsed and refractory AA-PNH syndrome.
