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Titolo:
Immunosuppressive therapy using antithymocyte globulin, cyclosporine, and danazol with or without human granulocyte colony-stimulating factor in children with acquired aplastic anemia
Autore:
Kojima, S; Hibi, S; Kosaka, Y; Yamamoto, M; Tsuchida, M; Mugishima, H; Sugita, K; Yabe, H; Ohara, A; Tsukimoto, I;
Indirizzi:
Japan Childhood Aplast Anemia Study Grp, Nagoya, Aichi, Japan Japan Childhood Aplast Anemia Study Grp Nagoya Aichi Japan Aichi, Japan
Titolo Testata:
BLOOD
fascicolo: 6, volume: 96, anno: 2000,
pagine: 2049 - 2054
SICI:
0006-4971(20000915)96:6<2049:ITUAGC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; SAA-WORKING-PARTY; ANTILYMPHOCYTE GLOBULIN; CYTOGENETIC ABNORMALITIES; LEUKEMIA; ADULTS; CSF;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Kojima, S Nagoya Univ, Sch Med, Dept Dev Pediat, Showa Ku, 65 Tsurumai-chou, Nagoya,Aichi 4668550, Japan Nagoya Univ 65 Tsurumai-chou Nagoya Aichi Japan 4668550 0, Japan
Citazione:
S. Kojima et al., "Immunosuppressive therapy using antithymocyte globulin, cyclosporine, and danazol with or without human granulocyte colony-stimulating factor in children with acquired aplastic anemia", BLOOD, 96(6), 2000, pp. 2049-2054

Abstract

A prospective multicenter trial of 119 children 1 to 18 years of age with newly diagnosed aplastic anemia (AA) was conducted, comparing treatment using antithymocyte globulin (ATG), cyclosporine (CyA), and danazol (DAN) withor without rh(jr-CSF (400 mu g/m(2), day on days 1-90), All children with very severe AA received rhG-CSF (VSAA group, n = 50), The other children were randomized to receive ATG, CyA, DAN, and rhG-CSF (G-CSF+ group, n = 35) or ATG, CyA, and DAN without rhG-CSF (G-CSF-group, n = 34), After 6 months,the hematologic response rate was 71%, 55%, and 77% in the VSAA group, G-CSF+ group, and G-CSF- group, respectively. There was no difference in the incidence of febrile episodes and documented infections between the G-CSF+ and G-CSF- groups. Bone marrow transplantation (BMT) was attempted in 22 patients in whom initial immunosuppressive therapy (IST; n = 18) failed or in whom a relapse occurred after an initial response (n = 4). Nineteen of the 22 patients are alive and well after a median follow-up of 18 months (range, 3 to 66 months) since BMT. The probability of survival at 4 years was 83%+/- 7% in the VSAA group, 91% +/- 5% in the G-CSF+ group, and 93% +/- 6% in the G-CSF- group. Myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) developed in one patient in each of the three groups; the overall riskfor MDS/AML was 3% +/- 2% at 4 years, Because the results of IST were encouraging, it is suggested that children with AA receive IST as first-line therapy if there is no human leukocyte antigen-matched sibling donor, (Blood.2000;96:2049-2054) (C) 2000 by The American Society of Hematology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 22:40:52