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Response to cyclosporine A and corticosteroids in adult patients with acquired pure red cell aplasia: serial experience at a single center

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Abstract

To assess response to cyclosporine A, and/or corticosteroids, and possible factors influencing the response in adult patients with acquired pure red cell aplasia (PRCA). Clinical data from 42 cases were retrospectively analyzed. These patients received cyclosporine A (CsA), and/or corticosteroids (CS), or other immunosuppressive agents on becoming refractory and relapse. Thirty-nine patients were evaluated. Remission induction therapy included CsA (n = 16), CS (n = 13), CsA in combination with CS (n = 6), or other immunosuppressive agents (n = 4). Initial response rates were 75.0, 46.2, 66.7 and 75.0%, respectively (P = 0.456). Cumulative response rates in patients who received CsA, CS, CsA in combination with CS, or other immunosuppressive agents were 69.6% (16/23), 50.0% (7/14), 71.4% (5/7), 42.9% (6/14), respectively (P = 0.376). Cumulative rates of CR were 26.1% (6/23), 28.6% (4/14), 57.1% (4/7), 14.3% (2/14), respectively (P = 0.284). In 27 refractory and relapsed PRCA patients, 11 of 17 patients (64.7%) achieved remission by CsA and/or CS regimen, while three of ten patients (30.0%) responded to other immunosuppressive agents (P = 0.120). CsA and/or CS were effective in treating PRCA. For patients with relapse or refractory PRCA, there were no satisfactory treatments if CsA and/or CS failed or were not administered.

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Authors and Affiliations

  1. Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Hematology of Nanjing Medical University, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Guangzhou Road 300#, Nanjing, 210029, Jiangsu, China

    Xuemei Wu, Suli Wang, Xingyu Lu, Wenyi Shen, Chun Qiao, Yujie Wu, Ruinan Lu, Shuai Wang, Jianfu Zhang, Ming Hong, Yu Zhu, Jianyong Li & Guangsheng He

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  1. Xuemei Wu
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  2. Suli Wang
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  3. Xingyu Lu
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  4. Wenyi Shen
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  5. Chun Qiao
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  6. Yujie Wu
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  7. Ruinan Lu
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  11. Yu Zhu
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  13. Guangsheng He
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Correspondence to Guangsheng He.

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Informed consent was obtained from all individual participants included in the study.

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Wu, X., Wang, S., Lu, X. et al. Response to cyclosporine A and corticosteroids in adult patients with acquired pure red cell aplasia: serial experience at a single center. Int J Hematol 108, 123–129 (2018). https://doi.org/10.1007/s12185-018-2446-y

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  • DOI: https://doi.org/10.1007/s12185-018-2446-y

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