Analysis of the Prognostic Factors of Very Severe Aplastic Anemia Treated with Chinese Kidney-Invigorating Drugs in Combination with Anti-lymphocyte Globulin or Anti-thymocyte Globulin

Objective:To explore the prognostic factors for very severe aplastic anemia（VSAA） patients treated mainly with Chinese Kidney（Shen）-invigorating drugs（CKID） combined with anti-lymphocyte globulin （ALG） or anti-thymocyte globulin（ATG）.Methods:Twenty-seven VSAA patients were treated with CSID+ALG/ ATG therapy in conjunction with cyclosporine A,androgen,hemopoietic growth factor,etc.The relationship of the effectiveness and some factors（age of patients,course of illness,blood and bone marrow figures, etc.） were analyzed.Results:In the 25 evaluated VSAA patients who had been followed up for over 1 year,9 patients（36.0%） were basically cured,5（20.0%） remitted,6（24.0%） were markedly improved,and 5（20.0%） were treated in vain,with the total effective rate of treatment being 80.0%（20/25）.Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA,of male sex（P=0.037）,>20 years old（P=0.045）, with an illness course≤1 month（P=0.048）,with peripheral neutrophil count>0.1×10;/L（P=0.023）,and with reticulocyte count>10×10;/L（P=0.002）.Platelet count（P=0.620） and bone marrow lymphocyte percentage （P=0.736） showed no correlation with the therapeutic effectiveness.Multi-factor analysis by the Kaplan-Meier procedure on the factors influencing survival showed that rather longer survival times occurred in patients>20 years old,with peripheral neutrophil count≤0.1×10;/L,reticulocyte count<10×10;/L,and platelet count>10×10;/L（all P=0.0001）.Bone marrow lymphocyte percentage and the initiation time of ALG/ATG application （from onset of the illness） showed no significant influence on patients’ survival time（P=0.085 and P=0.935, respectively）.Conclusions:CSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients’ survival rate.Conditions including male sex,age>20 years,illness course<1 month,neutrophil count>0.1×10;/L,and reticulocyte count>10×10;/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.