抗淋巴细胞球蛋白为主的免疫抑制剂治疗重型再生障碍性贫血疗效分析

目的探讨以抗淋巴细胞球蛋白(ALG)为主的免疫抑制剂治疗重型再生障碍性贫血(SAA)的疗效。方法对2002年4月-2009年10月收治的137例诊断为SAA并接受ALG治疗的患儿临床资料进行回顾性分析,其中重型再生障碍性贫血Ⅰ型(SAA-Ⅰ型)103例、极重型再生障碍性贫血(vSAA)34例。结果 SAA-Ⅰ型组治疗有效率和显效率分别为73.8%和56.3%,vSAA组为67.6%和47.1%,疗效差异无统计学意义(P>0.05)。SAA-Ⅰ型组过敏反应和血清病反应发生率分别为32.0%和52.4%,vSAA组为50.0%和50.0%,两者差异无统计学意义(P>0.05)。SAA-Ⅰ型组3年生存率和复发率分别为95.6%和5.8%,vSAA组为87.2%和11.4%,两者差异无统计学意义(P>0.05)。结论以ALG为主的免疫抑制剂治疗SAA疗效肯定,对于vSAA患儿同样有效。

Therapeutic effect of antilymphocyte globulin in severe and very severe aplastic anemia in children

Objective To explore the effect of antilymphocyte globulin (ALG) as a main regimen of immunosuppressive therapy on sever aplastic anemia (SAA-Ⅰ) and very sever aplastic anemia (vSAA) in children. Methods One hundred and thirty-seven children with severe aplastic anemia were treated with ALG from April of 2002 to October of 2009. Among them, 103 cases and 34 cases were diagnosed as SAA-Ⅰ and vSAA, respectively. Results The overall effective rate and completely response rate were 73.8% and 56.3% vs. 67.6% and 47.1% in SAA-Ⅰ and vSAA groups. There were no significant differences between two groups (P>0.05). The incidence rate of allergy and serum sickness were 32.0% and 52.4% vs. 50.0% and 50.0% in SAA-Ⅰ and vSAA groups. There were no significant differences between two groups (P>0.05). The 3-year survival rate and relapse rate were 95.6% and 5.8% vs. 87.2% and 11.4% in SAA-Ⅰ and vSAA groups. There were no significant differences between the two groups (P>0.05). Conclusions ALG as a main regimen of immunosuppressive therapy is effective for both SAA-Ⅰ and vSAA.