RESUMO
Immunosuppressive therapy is the treatment of choice in children with acquired severe aplastic anemia (AA) and no HLA-matched family donor. The paper presents results of a multicenter study of 63 children with AA treated with rabbit antithymocyte globulin (r-ATG) and cyclosporine A as the first line treatment in the years 1996-2012. Therapeutic effects were evaluated at Days 112, 180, and 360. At Day 112, remission was achieved in 28 out of the 63 patients (44.4 %), complete remission in 10 patients (15.9 %), and partial remission in 18 (28.5 %). At Day 180, 31 patients (49.2 %) were in remission including 15 cases in complete (23.8 %), and 16 cases in partial remission (25.4 %). One year after therapy onset, 34 patients (64.9 %) were in remission including 24 patients (38.0 %) in complete and 10 (15.9 %) in partial remission. Relapse occurred in 4 patients, from 8 months up to 2 years and 2 months after remission. One child, 5 years after remission, was diagnosed with paroxysmal nocturnal hemoglobinuria. The estimated 10-year overall survival rate and 10-year event-free survival rate were 67 % and 57 %, respectively.
Assuntos
Anemia Aplástica/terapia , Soro Antilinfocitário/uso terapêutico , Terapia de Imunossupressão/métodos , Imunossupressores/uso terapêutico , Adolescente , Anemia Aplástica/imunologia , Anemia Aplástica/mortalidade , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Coelhos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
In the Department of Paediatric Hematology and Oncology (University School of Medicine in Wroclaw) 25 patients, 1 to 19 years old, 8 boys and 17 girls, suffering from germ cell tumors were treated from June 1989 to August 1998. In the course of the treatment both surgery, chemotherapy and radiotherapy were used. The level of oncological markers: alpha-fetoprotein (AFP), lactic dehydrogenase (LDH), carcinoembryonal antigen (CEA), beta-choriongonadotropin (beta-HCG) and CA 125 was examined at the beginning, during the therapy, and at the end of the treatment. Increased levels of oncological markers were found: AFP in 17 children, LDH in 10 children, CEA in 3 children, beta-HCG in 3 children and CA 125 in 2 children. In all cases the level of AFP was decreasing during the therapy. Normal levels of AFP and LDH were observed in children with complete remission. The use of AFP in diagnostics and monitoring of germ cell tumors was proved.
