[Increasing peripheral blood neutrophils after G-CSF treatment is a predictor of early response to immunosuppressive therapy in severe aplastic anemia].

Abstract

OBJECTIVE:

To testify whether absolute neutrophil count (ANC) response to preimmunosuppressive-therapy (pre-IST) granulocyte-stimulating factor (G-CSF) treatment could predict early response to IST in severe aplastic anemia (SAA).

METHODS:

Clinical data and hematologic response of 125 SAA patients treated with antithymocyte globulin (r-ATG) combined with cyclosporine were retrospectively analyzed. Correlation of ANC response to pre-IST G-CSF treatment and early response to IST were statistically analyzed, and receiver operating characteristic (ROC) curve was used to estimate the value of increased ANC (∆ANC) in predicting early IST response.

RESULTS:

The hematologic response (HR) rate to IST in ANC reponded patients was significantly higher than non-responded group (3-month HR 49.0% vs 28.9%, P=0.023; 6-month HR 61.2% vs 40.8%, P=0.026). With ∆ANC≥0.5×10⁹/L as cutoff level, the best point to predict early IST response was 10 days after G-CSF (d 10). Response of ANC to pre-IST G-CSF treatment at d 10 was among the independent factors of predicting 3-month (P=0.004), but not for 6-month response to IST. The overall 5-year survival rate was 92.8% and 69.5% in ANC responded and non-responed groups, respectively (P=0.025).

CONCLUSION:

Responding to pre-IST G-CSF treatment reflected the residual bone marrow hematopoiesis, and could act as a convenient and practical predictor to early IST response as well as long-term survival in SAA.

• Authors: Zhijie Wu, Wenrui Yang, Li Zhang, Liping Jing, Kang Zhou, Yang Li, Guangxin Peng, Lei Ye, Yuan Li, Jianping Li, Huihui Fan, Lin Song, Xin Zhao, Fengkui Zhang
• Journal: Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (Zhonghua Xue Ye Xue Za Zhi) Vol. 35 Issue 11 Pg. 974-9 (Nov 2014) ISSN: 0253-2727 [Print] China
• PMID: 25417872 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Granulocyte Colony-Stimulating Factor

Topics

• Anemia, Aplastic (drug therapy)
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Neutrophils (drug effects)