艾曲泊帕联合强化免疫抑制疗法治疗成人重型再生障碍性贫血疗效的预测因素  

Predictors of eltrombopag combining with intensive immunosupressive therapy efficacy in adults with severe aplastic anemia

作　　者：李瑞鑫 金媛媛 杨岩 林圣云[3] 贾晋松[4] 孟凡凯[5] 张东华[5] 龙启强[6] 何广胜[1] 李建勇[1] LI Ruixin;JIN Yuanyuan;YANG Yan;LIN Shengyun;JIA Jinsong;MENG Fankai;ZHANG Donghua;LONG Qiqiang;HE Guangsheng;LI Jianyong(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,210029,China;Department of Hematology,the First Affiliated Hospital of Jilin University;Department of Hematology,Zhejiang Province Hospital of Traditional Chinese Medicine;Department of Hematology,Peking University People's Hospital,Peking University Institute of Hematology;Department of Hematology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology;Department of Hematology,the Second Hospital of Nanjing)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院血液科,南京210029 [2]林大学第一医院血液科 [3]浙江省中医院血液科 [4]北京大学人民医院血液科 [5]华中科技大学同济医学院附属同济医院血液科 [6]南京市第二医院血液科

出　　处：《临床血液学杂志》2022年第5期333-337,共5页Journal of Clinical Hematology

摘　　要：目的:评价艾曲泊帕联合兔抗人胸腺细胞免疫球蛋白(ATG)和环孢素(CsA)强化免疫抑制疗法(IST)治疗中国成人重型再生障碍性贫血(SAA)的疗效及其预测因素。方法:收集61例成人SAA患者接受艾曲泊帕联合IST治疗的临床资料,评估相关影响因素。结果:IST治疗后3、6和12个月,累计总有效率分别为67%、79%和85%,累计完全缓解率分别为21%、22%和32%。治疗前网织红细胞百分比(AUC=0.784,95%CI 0.631~0.937,P=0.006)、红细胞分布宽度变异系数(AUC=0.737,95%CI 0.527~0.947,P=0.022)、淋巴细胞绝对计数(AUC=0.733,95%CI 0.563~0.903,P=0.025)或治疗前感染(AUC=0.705,95%CI 0.519~0.891,P=0.048)能预测艾曲泊帕联合IST治疗的疗效。结论:IST前淋巴细胞绝对计数、网织红细胞百分比、红细胞分布宽度变异系数或治疗前感染能预测成人SAA患者对艾曲泊帕联合IST治疗的疗效。Objective:To evaluate the efficacy and predictors of eltrombopag combining with antithymocyte immunoglobulin(ATG)and cyclosporin A(CsA)in the treatment of severe aplastic anemia(SAA)in Chinese adults.Methods:Clinical data of 61 adult SAA patients treated with eltrombopag combining with IST(ATG+CsA)were collected,and the related influencing fators were evaluated.Results:The cumulative overall response rate of eltrombopag in combination with IST in the 3 rd,6 th and 12 th month were 67%,79%and 85%,while the cumulative complete response rate in the 3 rd,6 th and 12 th month were 21%,22%and 32%,respectively.The percentage of reticulocyte(AUC=0.784,95%CI 0.631-0.937,P=0.006),the red cell distribution width-coefficient of variation(AUC=0.737,95%CI 0.527-0.947,P=0.022),the absolute lymphocyte count(AUC=0.733,95%CI 0.563-0.903,P=0.025),or infection before treatment(AUC=0.705,95%CI 0.519-0.891,P=0.048)were correlated with the efficacy of eltrombopag in combination with IST.Conclusion:The absolute lymphocyte count,the percentage of reticulocyte,the red cell distribution width-coefficient of variation before IST and infection before treatment can predict the efficacy of eltrombopag combined with IST in adult SAA patients.

关 键 词：重型再生障碍性贫血 艾曲泊帕 强化免疫抑制疗法 疗效 

分 类 号：R556.5[医药卫生—血液循环系统疾病]