Gluckman E, Devergie A, Poros A, Degoulet P
Br J Haematol. 1982 Aug;51(4):541-50. doi: 10.1111/j.1365-2141.1982.tb02817.x.
This is a report of the European Group of Bone Marrow Transplant (EGBMT) on the influence of immunosuppression (IS) on survival of patients with severe aplastic anaemia (SAA). Fourteen teams participated in this survey involving 170 cases treated from 1974 to December 1980. The 1 year survival was 62.7%. Three types of treatment were used: (1) anti-thymocyte globulin (ATG) alone, (2) anti-thymocyte globulin and haplo-identical related bone marrow infusion, and (3) high dose bolus-6-methyl-prednisolone (b-6 MePr). There was no statistical difference in survival between these three groups. Androgens did not modify survival. Blood counts before treatment had a significant prognostic value. Patients with less than 0.2 X 10(9)/l granulocytes and less than 10 X 10(9)/l reticulocytes had 40% 1 year survival; the others had more than 70% 1 year survival. Patients with complete or partial reconstitution had the same good prognosis. In contrast, patients with no improvement after IS had a 27% 1 year survival. Several successive courses of IS improved the prognosis of non-responding patients. This survey confirms that IS improves the survival of patients with SAA. A prospective study will be performed to define the best and safest form of IS and to correlate clinical results with in vitro tests.
这是欧洲骨髓移植组（EGBMT）关于免疫抑制（IS）对重型再生障碍性贫血（SAA）患者生存率影响的一份报告。14个团队参与了这项调查，涉及1974年至1980年12月期间治疗的170例患者。1年生存率为62.7%。采用了三种治疗方式：（1）单独使用抗胸腺细胞球蛋白（ATG），（2）抗胸腺细胞球蛋白和单倍体相合相关骨髓输注，以及（3）大剂量冲击性6-甲基泼尼松龙（b-6 MePr）。这三组之间的生存率无统计学差异。雄激素并未改变生存率。治疗前的血细胞计数具有显著的预后价值。粒细胞低于0.2×10⁹/L且网织红细胞低于10×10⁹/L的患者1年生存率为40%；其他患者1年生存率超过70%。完全或部分恢复的患者预后同样良好。相比之下，免疫抑制后无改善的患者1年生存率为27%。多次连续的免疫抑制疗程改善了无反应患者的预后。这项调查证实免疫抑制可提高SAA患者的生存率。将进行一项前瞻性研究，以确定免疫抑制的最佳和最安全形式，并将临床结果与体外试验相关联。
