Complex association of mean corpuscular volume and outcomes in patients with aplastic anemia treated with cyclosporine A plus androgen or cyclosporine A alone.

The aim of this study was to explore the prognostic value of mean corpuscular volume (MCV) in newly diagnosed aplastic anemia (AA) patients treated with cyclosporine A (CsA) plus androgen or CsA alone. The clinical data of 181 newly diagnosed patients with aplastic anemia from April 2008 to September 2020 in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. According to the MCV levels, the patients were divided into a high-MCV group (107/181) and a normal-MCV group (74/181). We investigated the effect of MCV outcomes in patients with AA. Between the high-MCV and normal-MCV groups, neutrophil count, red blood cell count, platelet count, reticulocyte count, disease severity, lymphocytes, and granulocytes were significantly different (P < 0.05). The overall response rates (CR + PR) were 69.16% and 59.46% in the high-MCV and normal-MCV groups, respectively. The duration of response was not significantly different between MCV groups. The high-MCV patients had an improved 5-year overall survival and progression-free survival compared to the normal-MCV patients (94.40% vs. 68.10%; 71.80% vs. 60.30%, P < 0.001). Regarding hemogram restoration, the leukocyte, neutrophil, hemoglobin, and platelet recovery was accelerated in the high-MCV group (P < 0.05). Furthermore, MCV levels were positively correlated with reticulocyte count, reticulocyte percentage, high-fluorescence reticulocyte, medium-fluorescence reticulocyte, and immature reticulocyte fraction; on the other hand, MCV levels were negatively correlated with low fluorescent reticulocyte. In conclusion, aplastic anemia patients with a high MCV were a better prognostic factor, and the patients with high MCV may have better residual bone marrow hematopoietic function than those with normal MCV.