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International Journal of Hematology
Published in: International Journal of Hematology 1/2018

01-01-2018 | Original Article

Modified immunosuppressive therapy with porcine antilymphocyte globulin plus delayed cyclosporine A in children with severe aplastic anemia

Authors: Qingya Cui, Pingping Sha, Haifei Chen, Hongshi Shen, Longmei Qin, Zhengyang Li, Tianqin Wu, Zhaoyue Wang

Published in: International Journal of Hematology | Issue 1/2018

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Abstract

Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine (CsA) is the standard treatment for children with severe aplastic anemia (SAA) with no human leukocyte antigen-matched siblings. Due to the unavailability of horse ATG in China, porcine antilymphocyte globulin (p-ALG), which is less expensive and more effective than rabbit ATG, is widely used. We sought to evaluate the efficacy and safety profile of modified IST with p-ALG plus delayed CsA at day 21 in 50 SAA children. Eighteen SAA patients who progressed from nonsevere aplastic anemia (NSAA) were classified as SAA-II; the other 32 patients were classified as SAA-I. Overall response (OR) rates at 3, 6 and 12 months were 56, 64 and 62%, respectively. The 10-year overall survival (OS) rate and disease-free survival (DFS) rate were 80 and 56%. The OR, OS and DFS rates in the SAA-I group were clearly better than those in the SAA-II group. Death rate from infection within 30 days was 4%. Modified IST with p-ALG plus delayed CsA is a reliable and well-tolerated treatment for children with SAA, and reduces early death due to infection. Modified IST is more suitable for children with SAA-I.
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Metadata
Title
Modified immunosuppressive therapy with porcine antilymphocyte globulin plus delayed cyclosporine A in children with severe aplastic anemia
Authors
Qingya Cui
Pingping Sha
Haifei Chen
Hongshi Shen
Longmei Qin
Zhengyang Li
Tianqin Wu
Zhaoyue Wang
Publication date
01-01-2018
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 1/2018
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-017-2321-2

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