International Journal of Hematology

DOI: 10.1007/s12185-018-2446-y Pages: 1-7

Response to cyclosporine A and corticosteroids in adult patients with acquired pure red cell aplasia: serial experience at a single center

1. Nanjing Medical University, Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Hematology of Nanjing Medical University, Collaborative Innovation Center for Cancer Personalized Medicine

Correspondence to:
Guangsheng He
Tel: +862568136034
Email: heguangsheng1972@sina.com

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Abstract

To assess response to cyclosporine A, and/or corticosteroids, and possible factors influencing the response in adult patients with acquired pure red cell aplasia (PRCA). Clinical data from 42 cases were retrospectively analyzed. These patients received cyclosporine A (CsA), and/or corticosteroids (CS), or other immunosuppressive agents on becoming refractory and relapse. Thirty-nine patients were evaluated. Remission induction therapy included CsA (n = 16), CS (n = 13), CsA in combination with CS (n = 6), or other immunosuppressive agents (n = 4). Initial response rates were 75.0, 46.2, 66.7 and 75.0%, respectively (P = 0.456). Cumulative response rates in patients who received CsA, CS, CsA in combination with CS, or other immunosuppressive agents were 69.6% (16/23), 50.0% (7/14), 71.4% (5/7), 42.9% (6/14), respectively (P = 0.376). Cumulative rates of CR were 26.1% (6/23), 28.6% (4/14), 57.1% (4/7), 14.3% (2/14), respectively (P = 0.284). In 27 refractory and relapsed PRCA patients, 11 of 17 patients (64.7%) achieved remission by CsA and/or CS regimen, while three of ten patients (30.0%) responded to other immunosuppressive agents (P = 0.120). CsA and/or CS were effective in treating PRCA. For patients with relapse or refractory PRCA, there were no satisfactory treatments if CsA and/or CS failed or were not administered.

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