单纯红细胞再障贫血细胞毒免疫抑制药物的治疗策略

来源 :国外医学.输血及血液学分册 | 被引量 : 0次 | 上传用户:dashiliangzeyi
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环磷酰胺(Cp)或硫唑嘌呤(Aza)联用强的松龙(P)治疗获得性纯红细胞再生障碍性贫血(PRCA)的初期缓解率仅40%。约有34-50%达不到缓解,平均缓解期24个月,大多复发。作者报道5例(PRCA)其血红蛋白值4.7-8.4g/dl,骨髓幼红细胞4例0.3-2%,1例10%。1例慢性粒单核细胞白血病,1例发展为难治性铁粒幼细胞贫血,1例良性胸腺瘤摘除后6年,1例合并溶血。初期治疗为Aza-P组3例,采用Aza2mg/kg加P25mg/日,分别1.5、2和5个月,Cp-P组2例采用Cp2mg/kg加P25mg/日治疗分别4和6个月。对初治方案耐药的病例更替使用Cp或Aza Initial response to acquired pure red cell aplasia (PRCA) with cyclophosphamide (Cp) or azathioprine (Aza) plus prednisolone (P) was only 40%. About 34-50% failed to alleviate the average remission of 24 months, most of the recurrence. The authors report 5 cases (PRCA) hemoglobin value 4.7-8.4g / dl, bone marrow erythroblasts in 4 cases 0.3-2%, 1 case of 10%. One case of chronic myelomonocytic leukemia, one case developed refractory ascitic neutrophil anemia, one case of benign thymoma 6 years after enucleation and one case had hemolysis. The initial treatment was Aza-P in 3 cases, with Aza2mg / kg plus P25mg / day for 1.5, 2 and 5 months respectively. Two patients in Cp-P group were treated with Cp2mg / kg plus P25mg / day for 4 and 6 months, respectively. Use of Cp or Aza for case-to-arm replacement of naive regimens
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