环孢素A联合雄激素治疗输血依赖非重型再生障碍性贫血预后因素分析

OBJECTIVE: To analyze the prognostic factors of transfusion-dependent non-severe aplastic anemia （TD-NSAA） patients treated with cyclosporine A （CsA） and androgen. METHODS: Clinical data of 77 consecutive TD-NSAA patients treated with CsA and androgen were retrospectively analyzed between 2010 and 2013. We obtained clinical manifestations and baseline parameters of routine blood test from responders, and compared those with non-responders. All data were analyzed by univariate analysis and multivariate analysis. RESULTS: In 77 patients, there were 43（55.8％） patients achieved hematological response after 6 months'treatment, and 53（68.8％）patients got response after 12 months. Univariate analysis showed that platelets baseline was the only factor related to hematological response［19（6–61）×10(9)/L vs 13.5（5–45）×10(9)/L，P＝0.001] after 6 months therapy. After 12 months, the statistical differences were maintained, which were platelets baseline［18（6–61）×10(9)/L vs 10.5（5–45）×10(9)/L, P<0.001］, absolute reticulocytes ［0.03（0.01–0.06）× 10(12)/L vs 0.029（0.02–0.06）× 10(12)/L，P＝0.043］, transfusion-dependent of platelet （P＝0.007）, transfusion-dependent of platelet and erythrocyte （P＝0.012）. Multivariate analysis showed that platelets baseline could be an independent prognostic factor of hematological response（P＝0.010 or 0.009）. Cutoff value of platelets by receiver operating characteristic curve was 15.5 × 10(9)/L. CONCLUSION: Baseline of higher platelets, higher reticulocyte, and no transfusion dependence of platelet are favorable prognostic factors. When platelets baseline is higher than 15.5×10(9)/L, CsA and androgen regimen is rational.