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>Journals >Revista de Hematología >Year 2016, Issue 2

Gutiérrez-Serdán R, López-Karpovitch X
Acquired aplastic anemia: a demographic, clinical, and therapeutic survey of a single institution in Mexico City
Rev Hematol Mex 2016; 17 (2)

Language: Inglés
References: 28
Page: 81-89
PDF: 400.31 Kb.

Full text


Background: Acquired aplastic anemia (AA) pathophysiology involves immune mechanisms. Risk classifications to stratify AA severity are employed to define treatment.
Objetive: To analyze therapeutic response and survival in patients with AA.
Patients and Method: A retrospective study was done in which diagnosis and therapy response were establish following 2009 AA British guidelines. Data collected from patients admitted between January 1998 and December 2007 were analyzed.
Results: In the study period 51 patients were identified. At diagnosis 2 of 19 cases had paroxysmal nocturnal hemoglobinuria clones. Median age in the remainder patients (22 females and 27 males) was 35 years (range 17 to 78 years). Eleven, 28 and 10 patients had non-severe, severe, and very severe AA, respectively. Seven patients with severe AA received bone marrow transplantation (BMT). All of them remain in complete response (CR) with a median follow-up of 1,675 days. Median survival in non-BMT patients (n=42) with nonsevere, severe, and very severe AA was 1,253, 895, and 447 days, respectively (p‹0.001). Forty patients received immunosuppressive therapy and androgens. Overall response (CR+PR; partial response) with immunosuppressive therapy and androgens was 51% and 38.5%, respectively. Overall response was significantly higher in BMT patients than in those treated with immunosuppressive therapy and androgens (p=0.002). No statistically significant difference in overall response was recorded between patients who received immunosuppression and androgens. Median survival in non-BMT patients with CR (1,577 days), PR (1,213 days) and no response (408 days) was statistically significant different (p‹0.02).
Conclusions: Long standing classifications are still useful to stratify survival and therapy response in AA. BMT remains the best therapeutic option, and seemingly immunosuppression and androgens render similar response rates in AA.

Key words: aplastic anemia, demography, epidemiology, survival, bone marrow transplantation, immunosuppression, androgens.


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