Abstract:OBJECTIVE: To evaluate the therapeutic effects of a combined immunotherapy, high-dose immunoglobulin (HDIG) plus cyclosporine A (CsA) plus prednisone (P), in children with aplastic anemia (AA) and to explore the association of peripheral blood lymphocyte subsets, peripheral blood cells and marrow CD34+ cells with therapeutic effects in AA. METHODS: The clinical data of 46 children with AA and who received the combined immunotherapy of HDIG + CsA + P were retrospectively studied. RESULTS: Of the 46 children with AA, 31 (67.4%) were responded to the combined immunotherapy. The binary logistic regression analysis showed low absolute neutrophil count (B=4.703, P<0.05), low percentage of peripheral blood CD4+ cells (B=0.142, P<0.05) and low ratio of peripheral blood CD4+/CD8+ （B=2.945, P<0.05）were associated with poor therapeutic effects. The ratio of CD34+/karyocytes of bone marrow in children with AA was lower than that in normal individuals, but it was not significantly related to the therapeutic effect. CONCXLUSIONS: The combined immunotherapy (HDIG+ CsA+P) was effective in children with AA. The absolute neutrophil count, the percentage of peripheral blood CD4+ and the ratio of peripheral blood CD4+/CD8+ were important prognostic factors in AA.［Chin J Contemp Pediatr, 2009, 11 (1):33-36］
