环孢菌素A在骨髓增生异常综合征中的应用

Application of Cyclosporine A in Myelodysplastic Syndrome——Review

骨髓增生异常综合征 (Myelodysplasticsyndrome ,MDS)的治疗目前尚无标准方案 ,而免疫学机制异常在其发病中的意义受到重视。本文对近年来国内外发表环孢菌素A(CsA)治疗MDS 10 5例 (按FAB诊断标准 :RA 90例、RARS 5例、RAEB 10例 )进行了总结。CsA的用法为 2 - 12mg/ (kg·d)持续用药 ,至少 3个月 ,疗效分析表明 6 4例血液学部分有效 ( 6 1.0 % ) ,14例完全缓解 ( 13.3% )。因此 ,IPSS分级为低危、中危 1及部分中危 2可选用CsA免疫抑制治疗 ,以减少输血次数 。

Treatment of myelodysplastic syndrome (MDS) remains unsatisfactory. It is possible that immunosuppressive therapy might be effective for a certain subset of patients with MDS. In this review 105 patients with MDS who were treated with cyclosporin A (CsA) including 90 RA, 5 RARS, 10 RAEB, were analyzed. The dose of CsA was 2-12 mg/(kg·d) for at least three months. Hematological improvement was observed in 64 patients (61%), and complete remission was observed in 14 patients (13.3%). These results indicated that CsA immunosuppressive therapy may be useful for IPSS low, intermediate 1 and intermediate 2 MDS patients.