两种免疫抑制疗法治疗儿童严重型再生障碍性贫血的比较

Two therapies for acquired severe aplastic anemia in children

目的 探讨提高儿童严重型再生障碍性贫血 (SAA)疗效的方法。方法 结合骨髓基质液体培养法及针对性应用重组人粒 巨噬细胞集落刺激因子 (rhuGM CSF) ,比较联合免疫抑制疗法(CIST)与强化免疫抑制疗法 (IIST)治疗SAA(分别为 11例和 16例 )的疗效。结果 在适当应用rhuGM CSF的基础上 ,CIST及IIST方案治疗儿童SAA疗效差异无显著性 (有效率分别为 82 %及81% )。结论 采用CIST及IIST方案联合适当rhuGM CSF治疗有助于进一步提高儿童SAA的疗效。

Objective To explore an effective regimen for acquired severe aplastic anemia (SAA) in children. Methods A prospective randomized clinical trial was conducted to compare the response rates of combined and intensive immunosuppressive therapies (CIST and IIST). In the meantime, the recombinant human granulocyte macrophage colony stimulating factor (rhuGM CSF) was used in SAA patients, and outcomes of marrow stroma culture from SAA patients were carried out. Results The effective rates of treating SAA children with CIST and IIST were no difference(82% and 81%, respectively) based on the application of rhuGM CSF. Conclusion CIST and IIST regimen with reasonable uses of rhuGM CSF might improve the response rate for treatment of SAA in childhood.