Hiệu quả điều trị của phác đồ Antithymocyte globulin kết hợp Cyclosporin A trên bệnh nhi suy tủy xương

Abstract

Aplastic anaemia is one of the most common blood diseases in children with challenging management and poor prognosis. This study aimed to evaluate the efficacies of immunosuppressive therapy using Antithymocyte globulin and Cylosporine for childhood aplastic anaemia. From January 2008 to January 2018, 37 children with aplastic anaemia were treated at the Pediatric Hematology department of the National Children’s Hospital. After 10-years and treatment and follow-up, the overall effectiveness rate is 70.3% (complete effectiveness rate: 43.3%; partial effectiveness rate: 27%). Effective result from immunosuppressive therapy was associated with the length of time between diagnosis and treatment and the time of Cylosporine treatment before dose reduction. The 10-years overall survival and event-free survival are 66.6% and 69.4%, respectively. Recurrence of aplastic anaemia occurred in 15.6% of the children, 2.7% of children progressed to myelodysplasia, and 10% who were monitored for CD55 and CD59 testing developed paroxysmal nocturnal haemoglobinuria. In conclusion, immunosuppressive therapy that include Antithymocyte immunosuppressive regimen combined with Cyclosporin A can be a good alternative for aplastic anaemia in children who lack a compatible stem cell donor.