EFFICACY OF INTRAVENOUS IMMUNOGLOBULIN IN THE TREATMENT OF AUTOIMMUNE HEMOLYTIC-ANEMIA - RESULTS IN 73 PATIENTS
EFFICACY OF INTRAVENOUS IMMUNOGLOBULIN IN THE TREATMENT OF AUTOIMMUNE HEMOLYTIC-ANEMIA - RESULTS IN 73 PATIENTS
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DOI：
10.1002/ajh.2830440404
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发表时间：
1993-12-01
影响因子：
12.8
通讯作者：
BUSSEL, JB
中科院分区：
文献类型：
--
作者：
FLORES, G;CUNNINGHAMRUNDLES, C;BUSSEL, JB
为了确定温抗体自身免疫性溶血性贫血（AIHA）是否对静脉注射丙种球蛋白（IVGG）治疗有反应，我们在三个机构进行了单独的试点研究，共招募了37例患者。我们将这些结果与文献中报道的36例IVGG治疗AIHA的回顾性研究相结合。检查了16个临床变量，以确定与IVGG反应的相关性。总体而言，73例患者中有29例（39.7%）对IVGG治疗有反应。两个变量与IVIG的良好反应密切相关：肝肿大（伴或不伴脾肿大）和治疗前血红蛋白低。在11名儿童中观察到了更好的反应趋势。总体而言，IVGG仅在1/3的患者中提供了急性获益，因此不能推荐作为AIHA的标准治疗。然而，在某些情况下，如治疗前血红蛋白< 6-7 gm/dl或肝肿大的患者，以及在其他治疗的毒性可能是重要考虑因素的临床环境中，它可能是有用的连续治疗。(C)1993 Wiley-Liss，Inc.
To determine whether warm-antibody autoimmune hemolytic anemia (AIHA) responds to treatment with intravenous gammaglobulin (IVGG), we conducted separate pilot studies at three institutions enrolling a total of 37 patients. We combined these results with a review of 36 cases of AIHA treated with IVGG reported in the literature. Sixteen clinical variables were examined to determine associations with response to IVGG. Overall, 29 of 73 patients (39.7%) responded to IVGG therapy. Two variables were strongly related to a good response to IVIG: the presence of hepatomegaly (with and without splenomegaly) and a low pre-treatment hemoglobin. A trend towards a better response was observed in the 11 children. Overall, IVGG provided acute benefit in only 1/3 of patients and therefore cannot be recommended as standard therapy for AIHA. It may, however, be useful as adjunctive treatment in selected cases, such as in those with a pre-treatment hemoglobin < 6-7 gm/dl or those with hepatomegaly, and in clinical settings where the toxicity of other treatments may be an important consideration. (C) 1993 Wiley-Liss, Inc.