雄激素治疗114例获得性非重型再生障碍性贫血患儿疗效分析

为分析雄激素治疗儿童获得性非重型再生障碍性贫血(non-severe aplastic anemia,NSAA)的疗效,本研究回顾性分析1996年1月-2009年1月在我院治疗的114例NSAA患儿临床资料。所有患儿均接受了康力龙0.1mg/(kg.d)治疗。结果表明,15例(13.2%)患儿在中位时间12个月(2-72个月)获得了完全缓解;6例(5.3%)患儿在中位时间19个月(6-72个月)进展为重型再生障碍性贫血(SAA);其余93例患者(81.6%)仍处于NSAA状态。分析各因素(包括性别、年龄、诊断初期中性粒细胞绝对值(ANC)、网织红细胞绝对(ARC)、血红蛋白,骨髓涂片中粒系/红系比例以及是否有输血依赖)与预后的关系发现,诊断初期伴输血依赖较无输血依赖患者更易进展为SAA(19.2%vs1.1%),两组间差异有统计学意义(p=0.016);诊断初期ARC低于50×109/L或ANC低于0.8×109/L易进展为SAA(8.1%vs0%)(p=0.029);(9.1%vs1.7%)(p=0.034),两者均低的患者更易进展为SAA(12.8%vs1.3%)(p=0.011)。结论 :给予康力龙治疗...

114 children with acquired non-severe aplastic anemia benefitted from androgen

This study was purposed to assess the efficacy of stanozolol for treatment of childhood patients with acquired non-severe aplastic anemia （NSAA）. The records of 114 children with acquired NSAA treated in hospital between January 1996 and January 2009 were analyzed retrospectively. All patients received stanozolol with the dose of 0.1 mg/（kg · d）. Some patients were treated with supportive care. The incidence and the risk factors of progression severe aplastic anemia（SAA） including gender, age, absolute neutrophil count, absolute reticulocyte count, dependent or independent of transfusion, the ratio of granulocytes and erythrocytes were evaluated. The results indicated that at a median follow-up of 52 months （range 5 - 181 ） ,6 patients （ 5.3% ） progressed into SAA, 93 （81.6%） remained in NSAA, and 15 （ 13.2% ） had complete remission. Patients with dependent of transfusion （platelet count 〈 10 ×10^9/L and/or haemoglobin 〈 70 g/L） have higher risk to progress into SAA （19.2% vs 1.1% ） （p = 0.016） ; patients with lower absolute neutrophil count（ANC） （ 〈 0.8 ×10^9/L） or with lower absolute reticulocyte count （ARC） （ 〈 40 ×10^9/ L） at diagnosis have higher risk to progress into SAA（8.1% vs 0% ） （p =0.029） ;（9. l% vs 1.7% ） （p =0.034） ; Those patients with lower ANC（ ANC 〈 0. 8 x 109/L） and lower ARC（ARC 〈 40 ×10^9/L） have higher risk into progress to SAA（ 19.2% vs 1.1% ） （p = 0. 016）. It is concluded that NSAA patients treated with Stanozolol progress into SAA with the rate of 5.3%. Those patients with dependent of transfusion or ANC 〈0.8 x 109/L or/and ARC 〈40 ×10^9/L have higher risk of process into SAA.