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재생불량성 빈혈에서 면역억제요법의 효과 -장기 추적관찰의 치료성적-
DC Field | Value | Language |
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dc.contributor.author | 민유홍 | - |
dc.date.accessioned | 2020-07-03T17:59:37Z | - |
dc.date.available | 2020-07-03T17:59:37Z | - |
dc.date.issued | 1997 | - |
dc.identifier.issn | 1225-0546 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/177949 | - |
dc.description.abstract | Background: There has been much evidence that immune-mediated stem cell injury may have a significant role in the pathogenesis of aplastic anemia, and as a result immunosuppressive therapy has become known as an effective treatment for patients with aplastic anemia. There have been no reports regarding the long-term follow-up of immunosuppressive therapy of patients with aplastic anemia in Korea. Therefore, we evaluated the response to immunosuppressive therapy for 47 patients with aplastic anemia, investigating the long-term survival, relapse rate and secondary clonal hematologic diseases. Methods: Antithymocyte globulin(ATG) or antilymphocyte globulin(ALG) was given with cyclosporin A(CsA) to 39 patients(ATG+CsA 27, ALG+CsA 12), and to 8 patients, ATG or ALG alone was given(ATG 6, ALG 2). ATG was administered for 5(or 8) days, and ALG was administered for 5 days. CsA was orally begun with ATG or ALG for a median total of 4.5(3∼14) months. Results: 1) Response: Among 47 patients, 30(63.8%) responded; 11 showed complete response(CR) and 19 showed partial response(PR). 2) Factors affecting response: Responses were equally distributed when patients were stratified for age, neutrophil counts and drug regimens. 3) Survival: Median duration of follow-up was 36(6∼84) months. Actuarial survival at 1 year was 100% in responders and 7.6% in nonresponders, and the 7-year actuarial survival rate was 94% and 76%, respectively(P value = 0.13). 4) Relapse: Relapse occurred in 4 of 30 responding patients. Relapse in patients with CR was not observed during follow-up. The risk of relapse was 12% at 2 years and 22% at 6 years. 5) Treatment outcome according to disease duration: There was no significant difference in response rate between patients treated within 4 months and beyond 4 months after diagnosis. But the latter group showed a significantly higher relapse rate than the former(4% vs 60%; P value = 0.01). 6) Side effects and complications: There were no serious side effects requiring discontinuation of immunosuppressive therapy. Evolution to secondary clonal hematologic diseases was not observed during follow-up. Conclusion: Our results of immunosuppressive therapy show the excellent long-term outcome. A prospective study is needed for the establishment of the adequate treatment duration of CsA and the follow-up period for the evaluation of the response of treatment. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | Korean | - |
dc.publisher | Korean Society of Hematology | - |
dc.relation.isPartOf | Korean Journal of Hematology (대한혈액학회지) | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | 재생불량성 빈혈에서 면역억제요법의 효과 -장기 추적관찰의 치료성적- | - |
dc.title.alternative | The Effect of Immunosuppressive Therapy on Aplastic Anemia - Long-Term Treatment Outcome - | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | 김성철 | - |
dc.contributor.googleauthor | 이석 | - |
dc.contributor.googleauthor | 정소영 | - |
dc.contributor.googleauthor | 유내춘 | - |
dc.contributor.googleauthor | 민유홍 | - |
dc.contributor.googleauthor | 한지숙 | - |
dc.contributor.googleauthor | 고윤웅 | - |
dc.contributor.localId | A01407 | - |
dc.relation.journalcode | J02034 | - |
dc.contributor.alternativeName | Min, Yoo Hong | - |
dc.contributor.affiliatedAuthor | 민유홍 | - |
dc.citation.volume | 32 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 67 | - |
dc.citation.endPage | 78 | - |
dc.identifier.bibliographicCitation | Korean Journal of Hematology (대한혈액학회지), Vol.32(1) : 67-78, 1997 | - |
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