| Title | Long-term outcome of patients with acquired primary idiopathic pure red cell aplasia receiving cyclosporine A. A nationwide cohort study in Japan for the PRCA Collaborative Study Group. | | Author(s) | Sawada KI, Hirokawa M, Fujishima N, Teramura M, Bessho M, Dan K, Tsurumi H, Nakao S, Urabe A, Omine M, Ozawa K | | Institution | Division of Haematologyand Oncology, Department of Medicine,Akita University School of Medicine,1-1-1 Hondo,Akita 010-8543,Japan. ksawada@doc.med.akita- u.ac.jp. | | Source | Haematologica 2007 Jul 20. | | Abstract | BACKGROUND AND
OBJECTIVES Cyclosporine A (CsA) has become one of the leading agents for the treatment of pure red cell aplasia (PRCA). However, further studies are necessary to determine the relapse-free survival (RFS) and overall survival (OS)of patients treated with this drug, the minimum duration of therapy for induction of remission,and whether or not there is need for maintenance treatment. DESIGN AND
METHODS Weconducted a nationwide survey in Japan. From a total of 185 patients (with 73 primaryidiopathic PRCAand 112 with secondary PRCA), we evaluated 62 patients with primaryidiopathic PRCA for this report.
RESULTS The remission induction therapy for these patients included CsA (n=31), corticos- teroids (CS) (n=20) or other drugs (n=11). CsA and CS produced remissions in 23 (74%) and 12 (60%) patients, respectively. The salvage treatment produced remis- sions in 58 patients (94%). Forty-one and 15 patients were maintained on CsA+/-CS (CsA-containing group) or CS alone (CS group), respectively. The median RFS in the CsA-containing group was 103 months, longer than that seen in the CS group (33 months) (p<0.01). Of 14 patients whose CsA was discontinued, 12 patients (86%) relapsed after a median of 3 months (range 1.5 to 40 months), while only 3 of 27 patients (11%) relapsed during CsA-containing maintenance therapy. Thus,the discon- tinuance of maintenance therapy was strongly correlated with relapse (p<0.001). Four patients in the CsA-containing group died; however,the OS of this group was not sig- nificantly different from that of the CS-groups (p=0.104). INTERPRETATION AND
CONCLUSIONS CsA-containing regimens sustain prolonged RFS more effectively than CS in primary idiopathic PRCA and seem to be important to prevent relapse. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17640861 |
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