High-dose cyclophosphamide compared with antithymocyte globulin for treatment of acquired severe aplastic anemia
High-dose cyclophosphamide compared with antithymocyte globulin for treatment of acquired severe aplastic anemia
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DOI：
10.1016/j.exphem.2013.01.001
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发表时间：
2013-04-01
影响因子：
2.6
通讯作者：
Wang, Jianxiang
中科院分区：
文献类型：
--
作者：
Zhang, Fengkui;Zhang, Li;Wang, Jianxiang
对重度或极重度再生障碍性贫血患者采用大剂量环磷酰胺（CTX）联合环孢素（CsA）的改良方案，并与抗胸腺细胞球蛋白（ATG）联合CsA方案进行疗效比较。本研究共有121例患者接受CTX加CsA（CTX组，48例）或ATG加CsA（ATG组，73例）治疗。 CTX组的早期死亡率为4.2%，ATG组的早期死亡率为8.2%，无显着差异（p = 0.312）。 CTX 和 ATG 组的总有效率分别为 3 个月时 54.2% 和 57.5%、6 个月时 64.6% 和 72.6%、12 个月时 72.9% 和 78.1%（p > 0.05）。 CTX组和ATG组的总体5年生存率分别为81.2%和80.7%，无事件生存率分别为68.2%和67.3%（p > 0.05）。 CTX组的总医疗费用比ATG方案低54.8% (p = 0.000)。总之，用 CTX 加 CsA 治疗重度或极重度再生障碍性贫血的疗效与传统治疗方案相当，且成本更低。 (C) 2013 ISEH - 血液学和干细胞学会。由爱思唯尔公司出版
A modified regimen of high-dose cyclophosphamide (CTX) plus cyclosporine (CsA) was adopted for patients with severe or very severe aplastic anemia, and the effectiveness was compared with a regimen of antithymocyte globulin (ATG) plus CsA. A total of 121 patients enrolled in this study received either CTX plus CsA (CTX group, 48 cases) or ATG plus CsA (ATG group, 73 cases). The early death rate was 4.2% in the CTX group and 8.2% in the ATG group, showing no significant difference (p = 0.312). The total response rate in the CTX and ATG groups was 54.2% and 57.5% at 3 months, 64.6% and 72.6% at 6 months, and 72.9% and 78.1% at 12 months, respectively (p > 0.05). The overall 5-year survival rate was 81.2% and 80.7%, and the event-free survival rate was 68.2% and 67.3% in the CTX and ATG groups, respectively (p > 0.05). The total medical cost of the CTX group was 54.8% less than that of ATG regimen (p = 0.000). In summary, treatment of severe or very severe aplastic anemia with CTX plus CsA has effectiveness that is comparable to a conventional regimen and less costly. (C) 2013 ISEH - Society for Hematology and Stem Cells. Published by Elsevier Inc.