Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, 300# Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
The First Affiliated Hospital of Jilin University, 71# Xinming Street, Changchun, 130021, Jilin Province, China.
Ann Hematol. 2020 Mar;99(3):443-449. doi: 10.1007/s00277-020-03926-6. Epub 2020 Jan 22.
This current study retrospectively analyzed the clinical characteristics of 69 adult patients with acquired pure red cell aplasia (PRCA) including 40 elderly and 29 non-elderly patients from September 2009 to June 2019. The remission induction therapy regimens included cyclosporine A (CsA), corticosteroids (CS), or other immunosuppressive agents. The overall response rate was 55% (22/40) in the elderly group compared with 75.9% (22/29) in non-elderly patients (P = 0.075). In elderly patients, the best remission was achieved in the group treated with CsA than those treated with CS or other immunosuppressive agents (83.3% vs 26.7% vs 42.9%%, P = 0.004). However, outcomes of remission were similar among different treatment groups (P = 0.458) in non-elderly patients. CS induced a higher response rate in the non-elderly than that in the elderly (88.9% vs 26.7%, P = 0.009). By univariate and multivariate analysis, the clinical efficacy of elderly patients with acquired PRCA was closely associated with an induction regimen of CsA (P = 0.009; P = 0.017). In conclusion, CsA might produce higher response rate than CS and other drugs in elderly patients with acquired PRCA.
本研究回顾性分析了 2009 年 9 月至 2019 年 6 月期间 69 例成人获得性纯红细胞再生障碍性贫血（PRCA）患者的临床特征，包括 40 例老年患者和 29 例非老年患者。缓解诱导治疗方案包括环孢素 A（CsA）、皮质类固醇（CS）或其他免疫抑制剂。老年组的总体缓解率为 55%（22/40），而非老年组为 75.9%（22/29）（P=0.075）。在老年患者中，CsA 治疗组的最佳缓解率优于 CS 或其他免疫抑制剂治疗组（83.3%比 26.7%比 42.9%，P=0.004）。然而，非老年患者中不同治疗组的缓解结果相似（P=0.458）。CS 在非老年患者中的缓解率高于老年患者（88.9%比 26.7%，P=0.009）。单因素和多因素分析显示，老年获得性 PRCA 患者的临床疗效与 CsA 诱导方案密切相关（P=0.009；P=0.017）。总之，CsA 可能在老年获得性 PRCA 患者中产生比 CS 和其他药物更高的缓解率。
