Clinical Observation of Combination Therapy of Anti-Thymocyte Globulin Cyclosporine A, Hemopoietic Growth Factor and Androgen for 47 Severe Aplastic Anaemia Cases.

For therapy to severe aplastic anaemia (SAA), the effective and survival rate of combination regime using anti-thymocyte globulin (ATG), globulin, cyclosporine A (CsA), hemopoietic growth factor and androgen are similar to those of hemopoietic stem cell transplantation(HSCT). we have treated 236 cases of SAA from Oct. 1995 to Dec. 2005. 47of them took combination therapy mainly with ATG. The range of age was 10 to 56 (median age was 32). Of all the patients, totle effective rate was 84.5%, 41% achieved complete remission and 43.5% got partial remission. With the median follow-up time of 53 months, 41 patients are survival (87.2%),6 died, 3 relapsed, 4 patients stayed the same, 1 coincided with PNH. The combination therapy mainly with ATG began to work after 1 to 11months (median time was 2.5 months). If one can be treated in 6 months after diagnosis, the effective rate can be 95% after 3 months’ management, but if not, it was only 43%. For patients whose bone marrow hemopoietic cell >30% before treatment, the effective rate was 87.5%, but if it<5%, the effective rate was only 15%. No patients was severely affected by allergy or serum disease caused by ATG during treatment. By using infection preventing method of platelet transfusion and supporting treatment, most of the patients went through risk time and showed therapeutic reaction. We believe that the combination therapy mainly with ATG is safe and effective for SAA. It is considerable for SAA patients without HLA matched donors.