Immunosuppressive therapy with anti-thymocyte globulin and cyclosporine A in selected children with hypoplastic refractory cytopenia

被引：31

作者：

Yoshimi, Ayami ^{[1
]}

Baumann, Irith ^{[2
]}

Fuehrer, Monika ^{[3
]}

Bergstraesser, Eva ^{[4
]}

Goebel, Ulrich ^{[5
]}

Sykora, Karl-Walter ^{[6
]}

Klingebiel, Thomas ^{[7
]}

Gross-Wieltsch, Ute ^{[8
]}

van den Heuvel-Eibrink, Marry M. ^{[9
]}

Fischer, Alexandra ^{[1
]}

Noellke, Peter ^{[1
]}

Niemeyer, Charlotte ^{[1
]}

机构：

[1] Univ Freiburg, Dept Pediat & Adolescent Med, Div Pediat Hematol & Oncol, Mathildenstr 1, D-79106 Freiburg, Germany

[2] Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany

[3] Ludwig Maximilians Univ Munchen, Children Hosp, Dr von Haunersches Kinderspital, Dept Pediat Hematol & Oncol, Munich, Germany

[4] Univ Zurich, Univ Childrens Hosp, Zurich, Switzerland

[5] Univ Dusseldorf, Dept Pediat Oncol Hematol & Immunol, Dusseldorf, Germany

[6] Hannover Med Sch, Dept Pediat Hematol Oncol, Hannover, Germany

[7] Goethe Univ Frankfurt, Univ Childrens Hosp, Frankfurt, Germany

[8] Olgaspital, Dept Pediat Hematol & Oncol, Stuttgart, Germany

[9] Erasmus MC, Sophia Childrens Hosp, Rotterdam, Netherlands

来源：

HAEMATOLOGICA | 2007年 / 92卷 / 03期

关键词：

myelodysplastic syndrome; refractory cytopenia; immunosuppressive therapy; anti-thymocyte globulin; children;

D O I：

10.3324/haematol.10683

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

It is currently unknown whether immunosuppressive therapy or hematopoietic stem cell transplantation is the most appropriate treatment strategy for children with refractory cytopenia and normal karyotype or trisomy 8. We report on 31 children with hypoplastic refractory cytopenia treated with immunosuppressive therapy consisting of antithymocyte globulin and cyclosporine. At 6 months, 22 of 29 eve luable patients had a complete or partial response; a total of ten patients achieved a complete response at varying time points. Six patients subsequently received a transplant because of non-response, progression to advanced myelodysplastic syndrome or evolution of monosomy 7. Overall and failure-free survival rates at 3 years were 88% and 57%, respectively.

引用

页码：397 / 400

页数：4

共 15 条

[1] Barrett J, 2000, SEMIN HEMATOL, V37, P15
[2] Immunosuppressive therapy for aplastic anemia in children:: a more severe disease predicts better survival
Führer, M
Rampf, U
Baumann, I
Faldum, A
Niemeyer, C
Janka-Schaub, G
Friedrich, W
Ebell, W
Borkhardt, A
Bender-Goetze, C
[J]. BLOOD, 2005, 106 (06) : 2102 - 2104
[3] A pediatric approach to the WHO classification of myelodysplastic and myeloproliferative diseases
Hasle, H
Niemeyer, CM
Chessells, JM
Baumann, I
Bennett, JM
Kerndrup, G
Head, DR
[J]. LEUKEMIA, 2003, 17 (02) : 277 - 282
[4] Refractory anemia in childhood:: a retrospective analysis of 67 patients with particular reference to monosomy 7
Kardos, G
Baumann, I
Passmore, SJ
Locatelli, F
Hasle, H
Schultz, KR
Stary, J
Schmitt-Graeff, A
Fischer, A
Harbott, J
Chessells, JI
Hann, I
Fenu, S
Rajnoldi, AC
Kerndrup, G
van Wering, E
Rogge, T
Nöllke, P
Niemeyer, CM
[J]. BLOOD, 2003, 102 (06) : 1997 - 2003
[5] Risk factors for evolution of acquired aplastic anemia into myelodysplastic syndrome and acute myeloid leukemia after immunosuppressive therapy in children
Kojima, S
Ohara, A
Tsuchida, M
Kudoh, T
Hanada, R
Okimoto, Y
Kaneko, T
Takano, T
Ikuta, K
Tsukimoto, I
[J]. BLOOD, 2002, 100 (03) : 786 - 790
[6] Prospective randomized multicenter study comparing cyclosporin alone versus the combination of antithymocyte globulin and cyclosporin for treatment of patients with nonsevere aplastic anemia: A report from the European blood and marrow transplant (EBMT) severe aplastic anaemia working party
Marsh, J
Schrezenmeier, H
Marin, P
Ilhan, O
Ljungman, P
McCann, S
Socie, G
Tichelli, A
Passweg, J
Hows, J
Raghavachar, A
Locasciulli, A
Bacigalupo, A
[J]. BLOOD, 1999, 93 (07) : 2191 - 2195
[7] Haematological response of patients with myelodysplastic syndrome to antithymocyte globulin is associated with a loss of lymphocyte-mediated inhibition of CFU-GM and alterations in T-cell receptor Vβ profiles
Molldrem, JJ
Jiang, YZ
Stetler-Stevenson, M
Mavroudis, D
Hensel, N
Barrett, AJ
[J]. BRITISH JOURNAL OF HAEMATOLOGY, 1998, 102 (05) : 1314 - 1322
[8] Antithymocyte globulin for treatment of the bone marrow failure associated with myelodysplastic syndromes
Molldrem, JJ
Leifer, E
Bahceci, E
Saunthararajah, Y
Rivera, M
Dunbar, C
Liu, J
Nakamura, R
Young, NS
Barrett, AJ
[J]. ANNALS OF INTERNAL MEDICINE, 2002, 137 (03) : 156 - 163
[9] Paediatric myelodysplastic syndromes and juvenile myelomonocytic leukaemia in the UK: a population-based study of incidence and survival
Passmore, SJ
Chessells, JM
Kempski, H
Hann, IM
Brownbill, PA
Stiller, CA
[J]. BRITISH JOURNAL OF HAEMATOLOGY, 2003, 121 (05) : 758 - 767
[10] Evaluation of dysplastic features in myelodysplastic syndromes: experience from the morphology group of the European Working Group of MDS in Childhood (EWOG-MDS)
Rajnoldi, AC
Fenu, S
Kerndrup, G
van Wering, ER
Niemeyer, CM
Baumann, I
[J]. ANNALS OF HEMATOLOGY, 2005, 84 (07) : 429 - 433

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