再生障碍性贫血患者环孢素单一疗法的疗效：印度东部一家三级护理医院的经验
Outcome of Cyclosporine Monotherapy in Patients of Aplastic Anemia: Experience of a Tertiary Care Hospital in Eastern India.
作者信息
Mandal Prakas Kumar, Baul Suvraneel, Dolai Tuphan Kanti, De Rajib, Chakrabarti Prantar
机构信息
Department of Hematology, Nilratan Sircar Medical College, 8C/1/N, Roy Para Road, Kolkata, WB 700050 India.
出版信息
Indian J Hematol Blood Transfus. 2017 Mar;33(1):144-147. doi: 10.1007/s12288-016-0706-7. Epub 2016 Jul 19.
INTRODUCTION
Immune suppression is a crucial pillar for treatment of aplastic anemia. Cyclosporine monotherapy is an easily available, affordable therapeutic option with good safety profile.
METHODS AND MATERIALS
This prospective study was conducted over a period of 2 years from June 2012 to July 2014. The diagnosis and response to treatment of aplastic anemia was established as per published criteria. Follow up was done at 3 and 6 months in order to assess the response.
RESULTS
57 patients of acquired aplastic anemia with median age of 37 years (6 to 81 years) were included in the study. 35 (62 %) cases were severe aplastic anemai, 16 (28 %) non severe aplastic anemia and 6 (10 %) were very severe aplastic anemia. At 3 months overall response rate (OR) was 7 (14 %) and at 6 months the OR rate of 11 (19.6 %) was achieved. Transiently raised creatinine, liver function abnormality and gum hypertrophy were the main side effects observed in this cohort.
CONCLUSION
Oral cyclosporine monotherapy at dose of 5 mg/kg/day is a relatively safe treatment option for resource poor patients with aplastic anemia.
引言
免疫抑制是再生障碍性贫血治疗的关键支柱。环孢素单一疗法是一种容易获得、价格实惠且安全性良好的治疗选择。
方法与材料
这项前瞻性研究于2012年6月至2014年7月进行，为期2年。再生障碍性贫血的诊断和治疗反应依据已发表的标准确定。在3个月和6个月时进行随访以评估反应。
结果
57例获得性再生障碍性贫血患者纳入研究，中位年龄37岁（6至81岁）。35例（62%）为重型再生障碍性贫血，16例（28%）为非重型再生障碍性贫血，6例（10%）为极重型再生障碍性贫血。3个月时总体缓解率（OR）为7例（14%），6个月时OR率达11例（19.6%）。该队列中观察到的主要副作用为肌酐短暂升高、肝功能异常和牙龈增生。
结论
对于资源匮乏地区的再生障碍性贫血患者，每日5mg/kg剂量的口服环孢素单一疗法是一种相对安全的治疗选择。
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