An Interim Report of AA97 Protocl for Acquired Aplastic Anemia in Childhood
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概要
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The results of a prospective multi-center trial applying combined immunosuppressive therapy (IST), childhood AA97 consisting of antithymocyte globulin (ATG) and cyclosporine (CyA), for children with acquired aplastic anemia (AA) are reported. Among 262 patients with data available, patients were subclassified into the following groups : 61, moderate AA; 84, severe AA; and 117, very severe AA. The hematopoietic response rate was 53%, 66% and 72%, respectively, 6 mo after treatment. A randomized trial of ATG, with or without CyA, was conducted for the moderate AA group, showing that the failure-free survival (FFS) rate is significantly higher for the CyA+ATG regimen than ATG alone (54.8% vs. 26.7%, <I>p</I>=0.0002). Second-line therapy was attempted for 60 patients of the severe and very severe AA groups, for which initial IST failed. Consequently, 31 patients received hematopoietic stem cell transplantation (SCT) from alternative donors and 21 patients without suitable SCT donors underwent a second IST. The FFS rate was significantly higher for the SCT from alternative donors than in repeated IST (83.9% vs. 9.5%, <I>p</I>=0.0001).
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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