环孢素A选择性治疗10例全血细胞减少患者的临床研究

Clinical Study on 10 Cases of Pancytopenia Selectively Treated by Cyclosporine A

本研究探讨环孢素A(CsA)选择性治疗网织红细胞(Ret)不低且伴乳酸脱氢酶(LDH)升高的全血细胞减少患者的疗效及不良反应。设定入选标准,用CsA对10例入组患者进行治疗,随访6-116月,评价疗效及不良反应。列举典型病例演示CsA在再生障碍性贫血(AA)伴LDH显著升高患者中的维持治疗作用。结果表明:10例患者诊断不同,但具有相似的临床及实验室特征,其中9例患者对CsA治疗有较好的反应,1例因肺结核终止治疗。结论:Ret不低伴LDH升高可能是CsA治疗全血细胞减少有反应的预测标记物。CsA选择性治疗可获得较高的反应性。CsA维持治疗是减少复发的重要因素。

This study was aimed to explore the effect and adverse reaction of cyclosporine A （CsA） in treatment of pancytopenia without reticulocyte decrease but with elevated LDH. 10 patients were selected according to our standards and were treated by CsA. The curative effect and adverse reaction of patients were evaluated by following up for 6 - 116 months. The effect of CsA in the maintenance treatment of AA patient with an obvious rise of LDH was illustrated by means of typical case. The results indicated that 10 patients had different diagnosis, but had similar clinical and laboratory characteristics. Among them, 9 patients showed a relatively good curative reaction to CsA. Treatment of 1 patient was stoped because of pneumotuberculosis. It is concluded that the elevated LDH without reticuleocyte decrease may be a biomarker to predict the curative reaction to CsA for patients with pancytopenia. Selectively treating pancytopenia with CsA can obtain a higher curative reaction and maintenance treatment with CsA is an important factor for reducing recurrence of this disease.