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Long-term follow-up of a novel immunosuppressive strategy of cyclosporine alternatively combined with levamisole for severe aplastic anemia.
- Source :
-
Annals of Hematology . Aug2020, Vol. 99 Issue 8, p1727-1734. 8p. - Publication Year :
- 2020
-
Abstract
- Hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine (CsA) have been widely accepted as the standard first-line treatments for severe aplastic anemia (SAA). However, most of the patients with SAA had a slim chance to access these strategies in developing countries. Here, we reported 10-year results in a cohort of 232 patients with SAA who received a novel IST of CsA, levamisole, and danazol (CsA&LMS-based regimen). The cumulative incidence of response was 52.1% at 6 months, 66.4% at 12 months, and 77.1% at 24 months. The 10-year overall survival (OS) and failure-free survival was 60.2% and 48.3%, respectively. Positive predictors of OS in multivariate analysis were higher pretreatment ANC, younger age, higher pretreatment absolute reticulocyte count (ARC), and response within 6 months. The probability of CsA&LMS discontinuation was 50.2% at 10 years. With a slow CsA&LMS taper, the actuarial risk for relapse was only 9.5%. The cumulative incidence of MDS/AML was 8.2% at 10 years. The long-term follow-up information demonstrated that the CsA&LMS regimen could be a promising strategy for patients with SAA in developing countries. [ABSTRACT FROM AUTHOR]
- Subjects :
- *APLASTIC anemia
*HEMATOPOIETIC stem cell transplantation
*ACTUARIAL risk
*CLINICAL trials
*COMPARATIVE studies
*CYCLOSPORINE
*IMIDAZOLES
*IMMUNOSUPPRESSION
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*PROGNOSIS
*RESEARCH
*EVALUATION research
*SEVERITY of illness index
DEVELOPING countries
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 99
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 144422878
- Full Text :
- https://doi.org/10.1007/s00277-020-04153-9