Clinical characteristics and prediction model of early death in severe/very severe aplastic anemia with immunosuppressive therapy

• Published in: Zhōnghuá xuèyèxué zázhì 2022-11, Vol.43 (11), p.916
• Main Authors: Chen, M, Zhuang, J L, Yang, C, Wang, W, Zhang, Y, Zhang, L, Zhao, D Q, Feng, J, Li, J, Zhou, D B, Han, B
• Format: Article
• Language: Chinese
• Subjects: Anemia, Aplastic - drug therapy; Antilymphocyte Serum - therapeutic use; Cerebral Hemorrhage - drug therapy; Cyclosporine - therapeutic use; Humans; Immunosuppression Therapy; Immunosuppressive Agents - therapeutic use; Models, Statistical; Mycoses; Prognosis; Retrospective Studies; Treatment Outcome
• ISSN: 0253-2727
• DOI: 10.3760/cma.j.issn.0253-2727.2022.11.006

Early death (ED) characteristics and predictive factors analysis in patients with severe/very severe aplastic anemia (SAA/VSAA) treated with intensive immunosuppression therapy and establish an ED prediction model. The clinical data of 232 patients with SAA/VSAA treated with Antithymocyte immunoglobulin (ATG) at the Peking Union Medical College Hospital from August 2003 to August 2021 were collected. The characteristics and causes of ED within 90 days were analyzed retrospectively. Cox proportional hazards model was used to screen the ED risk factors and build a prediction model. Only 19 patients (8.2% ) developed ED with a median time of 24 (3-85) days among the 232 patients with SAA/VSAA who received ATG treatment. The main cause of ED was infection (84.2% ) , followed by cerebral hemorrhage (10.5% ) . Multivariate analysis showed that VSAA ( =15.359, 95% 1.935-121.899, =0.010) , fungal infection prevention by posaconazole ( =0.147, 95% 0.019-1.133, =0.066) , lymphocyte count (LYM) ≤ 0.5×10(9)/L ( =3.386, 9