PMID- 32256799
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1792-0981 (Print)
IS  - 1792-1015 (Electronic)
IS  - 1792-0981 (Linking)
VI  - 19
IP  - 4
DP  - 2020 Apr
TI  - Risk factors associated with poor response to immunosuppressive therapy in 
      acquired aplastic anemia: A meta-analysis of retrospective studies.
PG  - 3104-3112
LID - 10.3892/etm.2020.8536 [doi]
AB  - Acquired aplastic anemia (AA) is a rare hematological disease characterized by 
      bone marrow hypocellularity and varying degrees of pancytopenia. 
      Immunosuppressive therapy (IST) is currently one of the first-line treatments for 
      AA; however, unresponsiveness remains a major concern. Although previous studies 
      have suggested several common risk factors for unresponsiveness, there are 
      currently no widely accepted predictors. Therefore, a meta-analysis of clinical 
      trials including information on factors associated with unresponsiveness of AA to 
      IST was performed in the present study. The PubMed, Embase and Cochrane Library 
      databases were searched for clinical studies on AA evaluating the association 
      between risk factors and unresponsiveness to IST. After the factors were defined 
      from the selected studies, the association between these factors and 
      unresponsiveness to IST was analyzed using Review Manager software. A total of 10 
      studies comprising 1,820 cases were included in the present meta-analysis. The 
      following factors were identified as predictors of unresponsiveness: Age (>/=60 
      years), sex, absolute neutrophil count, severity of the disease, paroxysmal 
      nocturnal hemoglobinuria clone, human leukocyte antigen (HLA)-DR2 and cytogenetic 
      abnormalities (CAs). Among these factors, only age (>/=60 years) [odds ratio 
      (OR)=1.65], HLA-DR2 negativity (OR=2.72) and CAs (OR=1.93) exhibited a 
      statistically significant association with unresponsiveness to IST (P=0.006, 
      P=0.04 and P=0.01, respectively). In conclusion, the present meta-analysis 
      revealed that age >/=60 years, HLA-DR2 negativity and CAs are risk factors for 
      unresponsiveness to IST. This result may enable clinicians to select an effective 
      therapeutic scheme for patients with AA and even provide novel clues to the 
      pathogenesis of AA.
CI  - Copyright: (c) Wang et al.
FAU - Wang, Jia
AU  - Wang J
AD  - Department of Pathology, Xinhua Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai 200092, P.R. China.
FAU - Shen, Ping
AU  - Shen P
AD  - Department of Pathology, Shanghai Children's Medical Center Affiliated to 
      Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China.
FAU - Wu, Xiangru
AU  - Wu X
AD  - Department of Pathology, Xinhua Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai 200092, P.R. China.
FAU - Jin, Wenjie
AU  - Jin W
AD  - Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong 
      University School of Medicine, Shanghai 201999, P.R. China.
LA  - eng
PT  - Journal Article
DEP - 20200219
PL  - Greece
TA  - Exp Ther Med
JT  - Experimental and therapeutic medicine
JID - 101531947
PMC - PMC7086236
OTO - NOTNLM
OT  - aplastic anemia
OT  - immunosuppressive therapy
OT  - meta-analysis
OT  - poor response
EDAT- 2020/04/08 06:00
MHDA- 2020/04/08 06:01
PMCR- 2020/02/19
CRDT- 2020/04/08 06:00
PHST- 2019/07/09 00:00 [received]
PHST- 2020/01/22 00:00 [accepted]
PHST- 2020/04/08 06:00 [entrez]
PHST- 2020/04/08 06:00 [pubmed]
PHST- 2020/04/08 06:01 [medline]
PHST- 2020/02/19 00:00 [pmc-release]
AID - ETM-0-0-8536 [pii]
AID - 10.3892/etm.2020.8536 [doi]
PST - ppublish
SO  - Exp Ther Med. 2020 Apr;19(4):3104-3112. doi: 10.3892/etm.2020.8536. Epub 2020 Feb 
      19.