Broliden Per Anders, Dahl Inger-Marie, Hast Robert, Johansson Bertil, Juvonen Eeva, Kjeldsen Lars, Porwit-MacDonald Anna, Sjoo Malvin, Tangen Jon-Magnus, Uggla Bertil, Oberg Gunnar, Hellstrom-Lindberg Eva
Karolinska Institutet, Department of Medicine, Karolinska University, Hospital Huddinge, Stockholm, Sweden.
Haematologica. 2006 May;91(5):667-70.
The present study evaluated the combination of antithymocyte globulin (ATG) and cyclosporine A (CsA) in patients with low-risk myelodysplastic syndromes. Twenty patients (17 with refractory anemia and 3 with refractory anemia with excess blasts) received treatment with rabbit-ATG plus CsA. The overall response rate was 30% (6/20); three of the six responders had a complete response. The responses lasted 2-58 months, with two patients still being in complete remission at 42 and 58 months. Short-lasting cytogenetic remissions were achieved in two patients. ATG was poorly tolerated in patients over 70 years of age. Four out of 20 patients progressed to acute myeloid leukemia within a year. We conclude that immunosuppressive treatment may be a therapeutic option for selected patients with myelodysplastic syndrome.
本研究评估了抗胸腺细胞球蛋白（ATG）与环孢素A（CsA）联合应用于低危骨髓增生异常综合征患者的疗效。20例患者（17例难治性贫血，3例伴有过多原始细胞的难治性贫血）接受了兔ATG加CsA治疗。总缓解率为30%（6/20）；6例缓解者中有3例完全缓解。缓解持续2至58个月，2例患者在42个月和58个月时仍处于完全缓解状态。2例患者实现了短期细胞遗传学缓解。70岁以上患者对ATG耐受性差。20例患者中有4例在1年内进展为急性髓系白血病。我们得出结论，免疫抑制治疗可能是部分骨髓增生异常综合征患者的一种治疗选择。
