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环孢素A治疗4例再生障碍性贫血

Cyclosporine A treatment in four cases of aplastic anemia.

作者信息

Porwit A, Panayotides P, Mansson E, Osby E, Hast R, Reizenstein P

出版信息

Blut. 1987 Feb;54(2):73-8. doi: 10.1007/BF00321033.

DOI:10.1007/BF00321033
PMID:2949787
Abstract

Cyclosporine A (CyA) treatment of 4 patients with severe aplastic anemia, who were ineligible for bone marrow transplantation, was carried out for periods of between 12 weeks to 20 months. A normalization of Hb and bone marrow, together with a marked improvement in WBC and platelet counts, were observed in only one of these four patients. The remission was maintained for 20 months under continuous treatment. A relapse occurred only when the patient himself interrupted treatment. No serious side effects were observed with CyA doses of 4-10 mg/kg/daily and blood concentrations of 200-400 ng/ml. No significant changes in T helper/T suppressor ratios were noted during the course of CyA treatment.

摘要

对4例不符合骨髓移植条件的严重再生障碍性贫血患者进行了环孢素A(CyA)治疗,治疗时间为12周至20个月。这4例患者中只有1例观察到血红蛋白和骨髓恢复正常,同时白细胞和血小板计数显著改善。在持续治疗下,缓解状态维持了20个月。仅在患者自行中断治疗时才出现复发。当CyA剂量为4 - 10mg/kg/每日且血药浓度为200 - 400ng/ml时,未观察到严重副作用。在CyA治疗过程中,未发现T辅助/T抑制细胞比值有显著变化。

相似文献

1
Cyclosporine A treatment in four cases of aplastic anemia.环孢素A治疗4例再生障碍性贫血
Blut. 1987 Feb;54(2):73-8. doi: 10.1007/BF00321033.
2
Cyclosporine A in five children with severe aplastic anemia.环孢素A治疗五例重型再生障碍性贫血患儿
Pediatr Hematol Oncol. 1990;7(1):89-98. doi: 10.3109/08880019009034322.
3
[Cyclosporin therapy for aplastic anemia].[环孢素治疗再生障碍性贫血]
Rinsho Ketsueki. 1990 Sep;31(9):1450-5.
4
Cyclosporin A (CyA) does not enhance CFU-c growth in patients with severe aplastic anaemia.环孢素A(CyA)不能促进重型再生障碍性贫血患者的集落形成单位 - 细胞(CFU - c)生长。
Scand J Haematol. 1985 Feb;34(2):133-6. doi: 10.1111/j.1600-0609.1985.tb02245.x.
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Severe aplastic anemia (SAA): response to cyclosporin A (CyA) in vivo and in vitro.重型再生障碍性贫血(SAA):环孢素A(CyA)在体内和体外的反应
Eur J Haematol. 1991 Apr;46(4):212-6. doi: 10.1111/j.1600-0609.1991.tb00543.x.
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Therapy of aplastic anemia with sequential antithymocyte globulin and cyclosporin.序贯使用抗胸腺细胞球蛋白和环孢素治疗再生障碍性贫血
Am J Hematol. 1991 Feb;36(2):144-6. doi: 10.1002/ajh.2830360214.
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Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. The German Aplastic Anemia Study Group.使用抗淋巴细胞球蛋白和甲泼尼龙联合或不联合环孢素治疗再生障碍性贫血。德国再生障碍性贫血研究组。
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Antithymocyte globulin and cyclosporine for severe aplastic anemia: association between hematologic response and long-term outcome.抗胸腺细胞球蛋白和环孢素治疗重型再生障碍性贫血:血液学反应与长期预后的关联
JAMA. 2003 Mar 5;289(9):1130-5. doi: 10.1001/jama.289.9.1130.
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Cyclosporine restores hematopoietic function by compensating for decreased Tregs in patients with pure red cell aplasia and acquired aplastic anemia.环孢素通过补偿纯红细胞再生障碍性贫血和获得性再生障碍性贫血患者中减少的调节性T细胞来恢复造血功能。
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10
Salvage therapy of refractory severe aplastic anemia by decreasing cyclosporine dose regimen.降低环孢素剂量方案治疗难治性重型再生障碍性贫血的挽救疗法。
Eur J Haematol. 2014 Feb;92(2):172-6. doi: 10.1111/ejh.12220. Epub 2013 Dec 2.

引用本文的文献

1
Cyclosporin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in immunoregulatory disorders.环孢素。对其药效学和药代动力学特性以及在免疫调节紊乱中的治疗应用的综述。
Drugs. 1993 Jun;45(6):953-1040. doi: 10.2165/00003495-199345060-00007.

本文引用的文献

1
In vitro tests for distinguishing possible immune-mediated aplastic anemia from transfusion-induced sensitization.用于区分可能的免疫介导的再生障碍性贫血与输血诱导的致敏反应的体外试验。
Blood. 1980 Feb;55(2):211-5.
2
Immune suppression of hematopoiesis in aplastic anemia: activity of T-gamma lymphocytes.再生障碍性贫血中造血的免疫抑制:Tγ淋巴细胞的活性
J Immunol. 1980 Oct;125(4):1449-53.
3
Treatment of aplastic anaemia with antilymphocyte globulin (ALG).用抗淋巴细胞球蛋白(ALG)治疗再生障碍性贫血。
Br J Haematol. 1983 Sep;55(1):7-16. doi: 10.1111/j.1365-2141.1983.tb01219.x.
4
Cyclosporine in refractory severe aplastic anemia.环孢素治疗难治性重型再生障碍性贫血
N Engl J Med. 1984 Mar 8;310(10):655-6. doi: 10.1056/NEJM198403083101013.
5
Immunosuppressive treatment of aplastic anemia as an alternative treatment for bone marrow transplantation.
Semin Hematol. 1984 Jan;21(1):11-9.
6
Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset.环孢素免疫抑制对近期发病的胰岛素依赖型糖尿病的影响。
Science. 1984 Mar 30;223(4643):1362-7. doi: 10.1126/science.6367043.
7
A randomized clinical trial of cyclosporine in cadaveric renal transplantation.
N Engl J Med. 1983 Oct 6;309(14):809-15. doi: 10.1056/NEJM198310063091401.
8
Antithymocyte globulin treatment in patients with aplastic anemia: a prospective randomized trial.再生障碍性贫血患者的抗胸腺细胞球蛋白治疗:一项前瞻性随机试验。
N Engl J Med. 1983 Jan 20;308(3):113-8. doi: 10.1056/NEJM198301203080301.
9
Cyclosporin A inhibits T-cell growth factor gene expression at the level of mRNA transcription.环孢菌素A在信使核糖核酸转录水平抑制T细胞生长因子基因的表达。
Proc Natl Acad Sci U S A. 1984 Aug;81(16):5214-8. doi: 10.1073/pnas.81.16.5214.
10
Effect of activated lymphocytes on the regulation of hematopoiesis: suppression of in vitro granulopoiesis by OKT8+Ia+T cells induced by alloantigen stimulation.活化淋巴细胞对造血调控的影响:同种异体抗原刺激诱导的OKT8 + Ia + T细胞对体外粒细胞生成的抑制作用。
J Immunol. 1984 Jan;132(1):160-4.