Survival after immunosuppressive therapy in children with aplastic anemia.

Abstract:

OBJECTIVE:To determine the survival of children =18 y, treated with immunosuppressive therapy (IST) using equine antithymocyte globulin (e-ATG) and cyclosporine (CsA). DESIGN:Prospective data entry as per a specified format. SETTING:Tertiary care hospital. PATIENTS:From January 1998 to December 2009, 40 children were diagnosed with acquired aplastic anemia; 33 patients, who received IST, were analyzed. 31 children (94%) received one course of e-ATG and CsA. 2 patients (6%) received two courses of ATG. INTERVENTION:Immunosuppressive therapy using equine ATG and cyclosporine. MAIN OUTCOME MEASURES:Overall response and overall survival. RESULTS:The overall response (complete response + partial response) to IST at 6 months was 87.9%. 8 (24.2%) patients achieved CR, 21 (63.6%) patients had PR and 4 (12.1%) patients did not respond to IST. Median follow-up was 24 (6-102) months. Overall survival at 24 months was 90%, with an actual survival of 85.4% at 5 years. Seventeen patients (51.5%) received G-CSF for a median duration of 32 (23-64) days. The patients who received G-CSF had fewer infectious complications (P=0.002), but G-CSF administration did not influence survival/ outcome. No patient developed myelodysplastic syndrome or acute leukemia. CONCLUSIONS:The survival of patients who respond to IST is excellent. Also, G-CSF reduces the infectious complications without conferring any survival advantage.

journal_name

Indian Pediatr

journal_title

Indian pediatrics

authors

Nair V,Sondhi V,Sharma A,Das S,Sharma S

doi

10.1007/s13312-012-0086-5

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

371-6

issue

5

eissn

0019-6061

issn

0974-7559

pii

S097475591100298-I

journal_volume

49

pub_type

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