Relative factors of relapse in children with aplastic anemia treated with antithymocyte globulin combined with cyclosporine / 中华实用儿科临床杂志

ABSTRACT

Objective To study the relative factors of relapse in children with aplastic anemia (AA) treated with antithymocyte globulin(ATG) combined with cyclosporine.Methods A retrospective analysis of the risk factors of relapse in children with AA after response to immunosuppressive therapy(IST).All patients received IST from Jan.2007 to Dec.2011 in the First Affiliated Hospital of Zhengzhou University.ISTATG 3 mg/(kg · d) × 5 d,cyclosporine 5-8 mg/(kg · d).Results (1) The basic cure rate was 29.4％ (25/85 cases),remission and obvious progress rate was 47.0％ (40/85 cases),and 20 cases were ineffective,the overall incidence of remission was 76.5％ (65/85 cases),basic cure,remission and obvious progress were considered as effective.The relapse rate was 12.3％ (8/65 cases).(2)Relapse was relative with cyclosporine concentration,infections episodes.And it was not relative with severity of disease,age,sex,duration of AA prior to initial treatment,severity of response.Conclusions A significant proportion of patients subsequently relapsed and required second-line therapy.Early IST,long-time continuation-maintenance of cyclosporine and the reduction of infectious episodes are important to prevent relapse.