%0 Journal Article
%T Clinical outcomes of immunosuppressive therapy for severe aplastic anemia patients with absolute neutrophil count of zero
%A Guang-Sheng He
%A Hua Yin
%A Jia Liu
%A Lang Cheng
%A Sheng-Yun Lin
%A Xiao-Qing Liu
%A Xing-Yu Lu
%A Xue-Mei Wu
%A Yan Yang
%J Hematology
%D 2019
%R https://doi.org/10.1080/16078454.2019.1631424
%X ABSTRACT Objectives: To evaluate the prognosis of adult severe aplastic anemia (SAA) patients with absolute neutrophil count (ANC) values of zero prior to immunosuppressive therapy (IST). Methods: Patients with ANC values of zero prior to IST were separated from very SAA and analyzed in a prospective study. All patients received IST with rabbit anti-thymocyte globulin (ATG) and cyclosporine (CsA). Results: A significantly lower response rate (RR) was identified in patients with ANC£¿=£¿0 prior to IST when compared to patients with SAA after both 3 and 6 month periods or compared to those with vSAA at 3 months only. The efficacy of IST was inversely related to ANC£¿=£¿0. The overall survival rate of the ¡®zero¡¯ group was significantly lower than that of the vSAA or SAA groups. Overall survival was closely associated with response to IST, and was inversely related to ANC£¿=£¿0. Discussion: In SAA patients, ANC is associated with prognosis, the elucidated overall survival improvement in patients without ANC£¿=£¿0 occurred in conjunction with decreased infection-related mortality. Our study revealed that adult patients with ANC£¿=£¿0 prior to IST responded poorly to IST, suggesting that having a very low number of neutrophils was a highly predictive factor for efficacy and survival of SAA patients treated with IST. Conclusion: Adult SAA patients with ANC£¿=£¿0 had a very poor prognosis and new therapeutic regimens may result in better outcome for these patients
%U https://www.tandfonline.com/doi/full/10.1080/16078454.2019.1631424