Erschienen in:
01.09.2013 | Original Article
A promising immunosuppressive strategy of cyclosporine alternately combined with levamisole is highly effective for moderate aplastic anemia
verfasst von:
Xingxin Li, Yingqi Shao, Meili Ge, Jun Shi, Jinbo Huang, Zhendong Huang, Jing Zhang, Neng Nie, Yizhou Zheng
Erschienen in:
Annals of Hematology
|
Ausgabe 9/2013
Einloggen, um Zugang zu erhalten
Abstract
The appropriate management of patients with moderate aplastic anemia (mAA) remains to be unclear and controversial. A cohort of 118 patients with mAA received a novel immunosuppressive strategy of cyclosporine alternately combined with levamisole (CSA and LMS regimen), which included 42 newly diagnosed and 76 chronic (disease duration >6 months) cases. CSA and LMS regimen was orally administrated with the initial dose of CSA 3 mg/kg per day in adults or 5 mg/kg per day in children, and LMS 150 mg per day in adults or 2.5 mg/kg per day in children, continued for 12 more months after achieving maximal hematologic response, followed by a slow tapering. The overall response rates were of 100 and 86.8 % for newly diagnosed and chronic group, respectively. The 24-month progression-free survival were 95.2 % (95 % confidence intervals [CI], 85.9–100 %) and 93.6 % (95 % CI, 86.9–100 %) for newly diagnosed and chronic group, respectively (P = 0.50). The 2-year event-free survival for the patients in newly diagnosed group (86.6 %; 95 % CI, 70.4–100 %) was superior to that in chronic group (57.0 %; 95 % CI, 43.5—70.4 %, P = 0.001). To date, 11 patients relapsed and no patients evolved to clonal disorders. Thus, CSA and LMS regimen represents a promising immunosuppressive strategy for mAA.