Korean J Hematol 2003; 38(1):
Published online March 31, 2003
© The Korean Society of Hematology
재생불량성빈혈 환자 137례의 치료 방법에 따른 생존율
손희정, 장근두, 신영록, 강혜진, 박사라, 김은경, 이경원, 이재련, 류민희, 최성준, 이제환, 김성배, 김상위, 이규형, 이정신, 김우건, 서철원
울산대학교 의과대학 내과학교실
Survival according to Treatment Modalities in 137 Patients with Aplastic Anemia
BACKGROUND: We performed this study to compare response rate and survival according to treatment modalities, such as allogeneic bone marrow transplantation (BMT), immunosuppressive therapy (IS) and androgen therapy in patients with aplastic anemia (AA).
METHODS : Medical records of one hundred and thirty-seven patients who diagnosed with aplastic anemia at the Asan Medical Center from September 1989 to December 2000 were retrospectively analyzed.
RESULTS : Forty-one patients received supportive care
only. Ninety-five out of 96 treated patients were evaluable for response. In severe AA group (N=79), the response rate according to treatment modalities was 25.0% in the androgen group (N=4), 30.3% in the ALG or ATG group (N=33), 25.0% in the cyclosporine (CSA) group (N=8), 44.4% in the ATG plus CSA group (N=9), and 73.8% in the BMT group (N=23) (P<0.001). Five- and 10-year survival of overall patients was 67.5% and 50.9%, respectively. Ten-year survival according to disease severity was 42.3% in severe AA group and 75.8% in non-severe AA group (P=0.0043). Five-year survival according to treatment modalities in patients with severe AA was 75.0% in the androgen group, 49.0% in the ALG or ATG group, 75.0% in the CSA group, and 88.9% in
the ATG plus CSA group. Five-year survival was 82.6% in the BMT group and 57.7% in the IS group (P=0.0259).
CONCLUSION : This study showes that BMT resulted in significantly better response rate and overall survival compared to IS in patients with severe AA.
Keywords Aplastic anemia; Bone marrow transplantation; Immunosuppressive therapy;
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Korean J Hematol 2003; 38(1): 1-7
Published online March 31, 2003
Copyright © The Korean Society of Hematology.
재생불량성빈혈 환자 137례의 치료 방법에 따른 생존율
손희정, 장근두, 신영록, 강혜진, 박사라, 김은경, 이경원, 이재련, 류민희, 최성준, 이제환, 김성배, 김상위, 이규형, 이정신, 김우건, 서철원
울산대학교 의과대학 내과학교실
Survival according to Treatment Modalities in 137 Patients with Aplastic Anemia
Hee Jung Sohn, Gunn Doo Jang, Young Rok Shin, Hye Jin Kang, Sa Rah Park, Eun Kyung Kim, Gyeong Won Lee, Jae Lyun Lee, Min Hee Ryu, Seong Jun Choi, Je Hwan Lee, Sung Bae Kim, Sang, We Kim, Kyoo, Hyung Lee, Jung Shin Lee, Woo Kun Kim, Cheolwon Suh
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
BACKGROUND: We performed this study to compare response rate and survival according to treatment modalities, such as allogeneic bone marrow transplantation (BMT), immunosuppressive therapy (IS) and androgen therapy in patients with aplastic anemia (AA).
METHODS : Medical records of one hundred and thirty-seven patients who diagnosed with aplastic anemia at the Asan Medical Center from September 1989 to December 2000 were retrospectively analyzed.
RESULTS : Forty-one patients received supportive care
only. Ninety-five out of 96 treated patients were evaluable for response. In severe AA group (N=79), the response rate according to treatment modalities was 25.0% in the androgen group (N=4), 30.3% in the ALG or ATG group (N=33), 25.0% in the cyclosporine (CSA) group (N=8), 44.4% in the ATG plus CSA group (N=9), and 73.8% in the BMT group (N=23) (P<0.001). Five- and 10-year survival of overall patients was 67.5% and 50.9%, respectively. Ten-year survival according to disease severity was 42.3% in severe AA group and 75.8% in non-severe AA group (P=0.0043). Five-year survival according to treatment modalities in patients with severe AA was 75.0% in the androgen group, 49.0% in the ALG or ATG group, 75.0% in the CSA group, and 88.9% in
the ATG plus CSA group. Five-year survival was 82.6% in the BMT group and 57.7% in the IS group (P=0.0259).
CONCLUSION : This study showes that BMT resulted in significantly better response rate and overall survival compared to IS in patients with severe AA.
Keywords: Aplastic anemia, Bone marrow transplantation, Immunosuppressive therapy,
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