ALG/ATG治疗非重型再生障碍性贫血

Antithymocyte Globulin/Antilymphocyte Globulin in the Treatment of Nonsevere Aplastic Anemia.

目的抗淋巴细胞球蛋白/抗胸腺细胞球蛋白(ALG/ATG)治疗环孢素 A(CsA)、雄激素、中药联合治疗无效或复发非重型再生障碍性贫血(NSAA)5例疗效观察并文献复习。方法选择华中选择科技大学同济医院附属协和医院的5例环孢素 A、雄激素、中药联合治疗6个月以上无效或复发 NSAA 患者,均需依赖输血,换用 ATG/ALG 治疗,随访观察疗效。结果 ATG/ALG 治疗5例 NSAA 患者基本治愈3例,明显进步2例,4例于90 d 内脱离输血,随访无复发及克隆氏病发生。结论对需依赖输血的 NSAA 患者,环孢素 A 治疗无效或复发后应及早换用 ATG/ALG 治疗,以减少输血引起的并发症和防止持续的骨髓免疫损伤。

Objective To observe the effectiveness of Antithymocyte globulin/antilymphocyte globulin(ATG/ALG)in the treatment of nonsevere aplastie anemia(NSAA)patients who didn't respond to cyclosporine A(CsA)or relapsed and review the literature.Methods We administered ATG/ALG to 5 NSAA patients who relapsed or showed no re- sponse after CsA therapy.Results 3 patients were cured,2 patients improved,4 patients became transfusion inde- pendent in 90 days,none relapsed or progressed to clonal disease.Conclusion Those NSAA patients who relapsed or showed no response after CsA therapy should be asministered ATG/ALG,so as to reduce transfusion complications and prevent sustained immune attack to the bone marrow.