Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study
Background Elderly patients with transfusion-dependent non-severe aplastic anemia (TD-NSAA) face limited treatment options owing to transplantation incompatibility and safety concerns.Methods Data from older patients (≥60 years) newly diagnosed with TD-NSAA and had been treated with either avatrombo...
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Taylor & Francis Group
2024-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2424451 |
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| author | Zhuxin Zhang Qinglin Hu Leyu Wang Chen Yang Miao Chen Bing Han |
| author_facet | Zhuxin Zhang Qinglin Hu Leyu Wang Chen Yang Miao Chen Bing Han |
| author_sort | Zhuxin Zhang |
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| description | Background Elderly patients with transfusion-dependent non-severe aplastic anemia (TD-NSAA) face limited treatment options owing to transplantation incompatibility and safety concerns.Methods Data from older patients (≥60 years) newly diagnosed with TD-NSAA and had been treated with either avatrombopag (AVA) + cyclosporine (CsA) or CsA monotherapy at our center were retrospectively collected.Results In total, 52 patients were enrolled, with 26 receiving AVA + CsA and 26 receiving CsA monotherapy. The overall response (OR) rate was higher in the AVA + CsA group than in the CsA group at the 1st, 2nd, 3rd, 6th months, and at the end of the follow-up (all p < 0.05). The complete response (CR) rate was higher in the AVA + CsA group than in the CsA group at the 6th month and at the end of follow-up (p = 0.017 and 0.039). Patients receiving AVA + CsA had a shorter time to achieve the first response (p = 0.008) and CR (p = 0.010) than those receiving CsA monotherapy. Furthermore, patients receiving AVA + CsA exhibited a higher rate of platelet transfusion independence at the 3rd (p = 0.041), 6th (p = 0.008) months, and likewise at the end of the follow-up (p = 0.097).Conclusions The addition of AVA to CsA can significantly improve the OR or CR rate and platelet levels with acceptable side effects in elderly patients, which implies that the combination is a viable alternative for elderly patients with TD-NSAA. |
| format | Article |
| id | doaj-art-3d737147ec3848ea85bdcf3b8519778c |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-3d737147ec3848ea85bdcf3b8519778c2024-11-27T03:29:52ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602024-12-0156110.1080/07853890.2024.2424451Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective studyZhuxin Zhang0Qinglin Hu1Leyu Wang2Chen Yang3Miao Chen4Bing Han5Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaDepartment of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaDepartment of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaDepartment of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaDepartment of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaDepartment of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, ChinaBackground Elderly patients with transfusion-dependent non-severe aplastic anemia (TD-NSAA) face limited treatment options owing to transplantation incompatibility and safety concerns.Methods Data from older patients (≥60 years) newly diagnosed with TD-NSAA and had been treated with either avatrombopag (AVA) + cyclosporine (CsA) or CsA monotherapy at our center were retrospectively collected.Results In total, 52 patients were enrolled, with 26 receiving AVA + CsA and 26 receiving CsA monotherapy. The overall response (OR) rate was higher in the AVA + CsA group than in the CsA group at the 1st, 2nd, 3rd, 6th months, and at the end of the follow-up (all p < 0.05). The complete response (CR) rate was higher in the AVA + CsA group than in the CsA group at the 6th month and at the end of follow-up (p = 0.017 and 0.039). Patients receiving AVA + CsA had a shorter time to achieve the first response (p = 0.008) and CR (p = 0.010) than those receiving CsA monotherapy. Furthermore, patients receiving AVA + CsA exhibited a higher rate of platelet transfusion independence at the 3rd (p = 0.041), 6th (p = 0.008) months, and likewise at the end of the follow-up (p = 0.097).Conclusions The addition of AVA to CsA can significantly improve the OR or CR rate and platelet levels with acceptable side effects in elderly patients, which implies that the combination is a viable alternative for elderly patients with TD-NSAA.https://www.tandfonline.com/doi/10.1080/07853890.2024.2424451Transfusion dependent non-severe aplastic anemiaelderlyavatrombopagcyclosporinethrombocytopenia |
| spellingShingle | Zhuxin Zhang Qinglin Hu Leyu Wang Chen Yang Miao Chen Bing Han Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study Annals of Medicine Transfusion dependent non-severe aplastic anemia elderly avatrombopag cyclosporine thrombocytopenia |
| title | Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study |
| title_full | Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study |
| title_fullStr | Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study |
| title_full_unstemmed | Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study |
| title_short | Cyclosporine plus avatrombopag versus cyclosporine monotherapy for first-line treatment of elderly patients with transfusion-dependent non-severe aplastic anemia: a single center retrospective study |
| title_sort | cyclosporine plus avatrombopag versus cyclosporine monotherapy for first line treatment of elderly patients with transfusion dependent non severe aplastic anemia a single center retrospective study |
| topic | Transfusion dependent non-severe aplastic anemia elderly avatrombopag cyclosporine thrombocytopenia |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2424451 |
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