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RISS 인기검색어
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- 저자 : 전의건 ( Jeon Ui Geon ) (검색결과 1 건)
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길준영 ( Gil Jun Yeong ),전의건 ( Jeon Ui Geon ),윤환중 ( Yun Hwan Jung ),김백수 ( Kim Baeg Su ),최용석 ( Choe Yong Seog ),조덕연 ( Jo Deog Yeon ),김삼용 ( Kim Sam Yong ) 대한내과학회 1993 대한내과학회지 Vol.44 No.3
Background : It is well konwn that aplastic anemia is more prevalent in the Far East than elsewhere in the world. There have been many suggestions that the clinical features of the patients with aplastic anemia in Korea would be somewhat different from that of western countries. Analysis of clinical data of 32 cases of aplastic anemia diagnosed at Chungnam National University Hospital from August 1985 to July 1991 was done. Methods : Initially all patients were treated with oxymetholone (50-100mg/d) with or without prednisolone (5-10mg/d) and supportive care. The patients who did not respond to androgen therapy were treated with antilymphocyte globulin (ALG) (20mg/kg/d for 4 days) plus methylprednisolne (methyl PD) (20mg/kg/d for 5 days). Analysis of reponse to therapy was done in 31 patients who could be followed for more than 3 months. Results : 12 patients (37.5%) were in their third decade and 25 cases of patients (78.2%) were below 40 years of age. The incidence decreased in older age groups. Exposure to possible toxic agents were seen in 6 cases (18.8%) ; benzene was counted in 2 cases (6.3%), herb drug in 2 cases (6.3%), antifungal agent in 1 case (3.1%). One case of aplastic anemia occured after acute viral hepatitis infection (type B) (3.1%), Eleven (35.5%) out of thity-one patients responded to androgen therapy (CR : 16.1%, PR : 19.4%). Nine out of the twenty patients who did not respond to androgen therapy were treated with ALG plus methyl PD. Two patients (22.2%) out of 9 showed complete responses. Overall response of present series of patients was 42% (oxymetholone±prednisolone therapy : 35.5%, ALG+methyl PD : 22.2%). By Kaplan-Meier product limit estimation, median survival time of 31cases was 36 months and the actuarial survival at 72 months was 83.1%. The median survival time of 31 cases was 36 months and the actuarial survival at 72 months was 83.1%. The median survival time of severe aplastic anemia (32 months) was similiar with that of moderately severe aplastic anemia (37 months). Factors associated with favourable survival were male sex and presence of etiological factor (p<0.05). Conclusions : In the present series, the survival rate of patients with aplastic anemia were somewhat different from that of western countries. Since the prognosis of patients with aplastic anemia in Korea is more favourable. A randomized controlled study would be needed to define the therapeutic role of bone marrow transplantation in patients with severe aplastic anemia in Korea.
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