Immunosuppressive therapy for elderly-acquired pure red cell aplasia: cyclosporine A may be more effective

Ann Hematol. 2020 Mar;99(3):443-449. doi: 10.1007/s00277-020-03926-6. Epub 2020 Jan 22.

Abstract

This current study retrospectively analyzed the clinical characteristics of 69 adult patients with acquired pure red cell aplasia (PRCA) including 40 elderly and 29 non-elderly patients from September 2009 to June 2019. The remission induction therapy regimens included cyclosporine A (CsA), corticosteroids (CS), or other immunosuppressive agents. The overall response rate was 55% (22/40) in the elderly group compared with 75.9% (22/29) in non-elderly patients (P = 0.075). In elderly patients, the best remission was achieved in the group treated with CsA than those treated with CS or other immunosuppressive agents (83.3% vs 26.7% vs 42.9%%, P = 0.004). However, outcomes of remission were similar among different treatment groups (P = 0.458) in non-elderly patients. CS induced a higher response rate in the non-elderly than that in the elderly (88.9% vs 26.7%, P = 0.009). By univariate and multivariate analysis, the clinical efficacy of elderly patients with acquired PRCA was closely associated with an induction regimen of CsA (P = 0.009; P = 0.017). In conclusion, CsA might produce higher response rate than CS and other drugs in elderly patients with acquired PRCA.

Keywords: Aplasia; Corticosteroids; Cyclosporine A; Elderly; Erythrocyte.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cyclosporine / administration & dosage*
  • Female
  • Humans
  • Immunosuppression Therapy*
  • Male
  • Middle Aged
  • Red-Cell Aplasia, Pure / drug therapy*
  • Red-Cell Aplasia, Pure / immunology
  • Red-Cell Aplasia, Pure / pathology
  • Remission Induction*

Substances

  • Cyclosporine