Clinical Study Of Immunosuppressive Therapy In Treatment Of Severe Aplastic Anemia

Objective: Severe Aplastic Anemia(SAA) is one of lethal diseases. Someyoung SAA patients should choose allogeneic hematopoietic stem celltransplantation if they have suitable donor, but standard front-line treatment forSAA for patients, who do not have an HLA identical family donor, is combinedimmunosuppressive therapy(IST). We collected the clinical data of38SAApatients who received ATG plus CsA therapy and30SAA patients whoreceived CsA therapy in the same period. We evaluated their clinical results inorder to find the clinical factors that may contribute to different outcomes ofthis treatment regimen. Besides, we took the side effects in concern so as tofind the way to prevent or treat them.Methods: From December2009to may2013, there were38SAA/VSAApatients were treated by ATG combined with CsA therapy and30SAA/VSAApatients were treated by CsA in our hospital, we chose them as the objects ofour study and compared the clinical efficacy and survival of the two groups.Results: The overall effective rate of ATG group were57.9%、73.7%、78.9%after treatment3months,6months,12months,and1-year survival rate was78.9%. The overall effective rate of CsA group were10%、20%、16.7%aftertreatment3months,6months,12months, and1-year survival rate was20%.The difference was statistically significant between the two groups(P <0.05). Individual data analysis of ATG group shows that the effective rate wasnot related with age sex, course of disease, and severe infection(P＞0.05).During the ATG treatment, the most common side effect was varying degreesof acute allergic reaction and serum disease（76%）, then was infection（53%）,Itcan be effectively controlled without affecting the integrity of the medicationATG.Conclusions: For the SAA/VSAA patients who are not suitable forhomatopoietic stem cell transplantation, ATG combined with CsA whichsignificantly better than single-use CsA is a standard therapy. We did not findthat the effective rate was related with age, sex, course of disease and infection.