International Journal of Hematology

, Volume 107, Issue 1, pp 64–68 | Cite as

Modified immunosuppressive therapy with porcine antilymphocyte globulin plus delayed cyclosporine A in children with severe aplastic anemia

  • Qingya Cui
  • Pingping Sha
  • Haifei Chen
  • Hongshi Shen
  • Longmei Qin
  • Zhengyang Li
  • Tianqin Wu
  • Zhaoyue Wang
Original Article


Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine (CsA) is the standard treatment for children with severe aplastic anemia (SAA) with no human leukocyte antigen-matched siblings. Due to the unavailability of horse ATG in China, porcine antilymphocyte globulin (p-ALG), which is less expensive and more effective than rabbit ATG, is widely used. We sought to evaluate the efficacy and safety profile of modified IST with p-ALG plus delayed CsA at day 21 in 50 SAA children. Eighteen SAA patients who progressed from nonsevere aplastic anemia (NSAA) were classified as SAA-II; the other 32 patients were classified as SAA-I. Overall response (OR) rates at 3, 6 and 12 months were 56, 64 and 62%, respectively. The 10-year overall survival (OS) rate and disease-free survival (DFS) rate were 80 and 56%. The OR, OS and DFS rates in the SAA-I group were clearly better than those in the SAA-II group. Death rate from infection within 30 days was 4%. Modified IST with p-ALG plus delayed CsA is a reliable and well-tolerated treatment for children with SAA, and reduces early death due to infection. Modified IST is more suitable for children with SAA-I.


Severe aplastic anemia Porcine antilymphocyte globulin Modified immunosuppressive therapy Infection 



This work was supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), Jiangsu Province’s Key Medical Center (ZX201102), and Life and health special funds of the Jiangsu Province’s Science and Technology Bureau (BL2012005).

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.


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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Qingya Cui
    • 1
  • Pingping Sha
    • 1
  • Haifei Chen
    • 2
  • Hongshi Shen
    • 2
  • Longmei Qin
    • 2
  • Zhengyang Li
    • 2
  • Tianqin Wu
    • 2
  • Zhaoyue Wang
    • 1
  1. 1.Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversityKey Lab of Thrombosis and Hemostasis of Ministry of HealthSuzhouChina
  2. 2.The Department of HematologyPLA 100th HospitalSuzhouChina

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