Chikkappa G, Pasquale D, Zarrabi M H, Weiler R J, Divakara M, Tsan M F
Medical Service, Department of Veterans Affairs Medical Centers, Albany, N.Y. 12208.
Am J Hematol. 1992 Sep;41(1):5-12. doi: 10.1002/ajh.2830410103.
We describe the characteristics of response to treatment with cyclosporine (CYA) plus prednisone in seven episodes of pure red cell aplasia (PRCA) in four patients with B cell chronic lymphocytic leukemia (CLL). Fourteen episodes of PRCA occurred in four patients with CLL. Eleven episodes were treated with conventional therapies which included an alkylating agent and prednisone. Four episodes that failed to respond to conventional therapies and an additional three episodes were treated with CYA and prednisone. Six of the seven episodes, including three of four which had failed conventional therapies, responded to CYA plus prednisone compared with six of eleven episodes treated with conventional therapies. Response to CYA and prednisone occurred without a reduction in leukemic mass. In contrast, PRCA remission did not occur until after leukemic mass reduction in three of four patients treated successfully with conventional therapies. Time to response was shorter (14 +/- 3 days) with CYA plus prednisone than with conventional therapies (154 +/- 97 days) in three of four patients. These results indicate that CYA plus prednisone is an effective therapy for the induction of remission from PRCA in patients with CLL.
我们描述了4例B细胞慢性淋巴细胞白血病（CLL）患者的7次纯红细胞再生障碍性贫血（PRCA）发作对环孢素（CYA）加泼尼松治疗的反应特征。4例CLL患者共发生14次PRCA发作。11次发作采用包括烷化剂和泼尼松在内的传统疗法治疗。4次对传统疗法无反应的发作以及另外3次发作采用CYA和泼尼松治疗。7次发作中的6次，包括4次中3次对传统疗法无效的发作，对CYA加泼尼松有反应，而11次采用传统疗法治疗的发作中有6次有反应。对CYA和泼尼松的反应发生时白血病细胞数量并未减少。相比之下，4例成功接受传统疗法治疗的患者中有3例直到白血病细胞数量减少后PRCA才缓解。4例患者中有3例使用CYA加泼尼松的反应时间（14±3天）比使用传统疗法（154±97天）短。这些结果表明，CYA加泼尼松是诱导CLL患者PRCA缓解的有效疗法。
