The clinical characteristics and therapy response of patients with acquired pure red cell aplasia

Hematology. 2018 Oct;23(9):639-645. doi: 10.1080/10245332.2018.1470068. Epub 2018 May 12.

Abstract

Objective: To summarize the clinical characteristics of acquired pure red cell aplasia (PRCA) patients diagnosed in our hospital in the last 10 years.

Method: The clinical features, immune state and treatment response of acquired PRCA patients diagnosed in our hospital from January 2007 to January 2017 were retrospectively analyzed.

Results: The results showed that thymoma (13.21%) and parvovirus B19 (11.32%) were the most common causes for secondary PRCA. Ferritin (Fer) levels and erythropoietin (EPO) levels were increased in PRCA patients. The total CR and PR rate of immunosuppressive therapy in our studies was 68.29% and 12.20%, respectively. Patients with EPO level >400 U/L and Fer level >200 ng/ml had significantly lower CR rate than others. The patients with EPO level >400 U/L also had longer hemoglobin recovery time than patients with EPO level ≤400 U/L. Patients treated with corticosteroids (CS) + cyclosporine A (CsA) had lower relapse rate compared to the CS group (29.17% vs. 80.00%, P < .05).

Conclusion: Our data showed that patients with PRCA had high EPO and Fer levels. Thymoma and viral infections are the most common causes for secondary PRCA. The CS+ CsA group had lower relapse rate than CS group although response rate was similar. Increased EPO and Fer levels might be the negative factors for prognosis of acquired PRCA.

Keywords: Pure red cell aplasia; idiopathic PRCA; immunosuppressive therapy; secondary PRCA.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Erythropoietin / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parvoviridae Infections* / blood
  • Parvoviridae Infections* / therapy
  • Parvovirus B19, Human*
  • Red-Cell Aplasia, Pure* / blood
  • Red-Cell Aplasia, Pure* / etiology
  • Red-Cell Aplasia, Pure* / therapy
  • Red-Cell Aplasia, Pure* / virology
  • Retrospective Studies
  • Thymoma* / blood
  • Thymoma* / therapy
  • Thymoma* / virology

Substances

  • EPO protein, human
  • Erythropoietin