Publication: Adult aplastic anemia in Thailand: incidence and treatment outcome from a prospective nationwide population-based study
Issued Date
2021-10-01
Resource Type
ISSN
14320584
09395555
09395555
Other identifier(s)
2-s2.0-85110772788
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of Hematology. Vol.100, No.10 (2021), 2443-2452
Suggested Citation
Lalita Norasetthada, Somchai Wongkhantee, Jindaratn Chaipokam, Kanyaporn Charoenprasert, Suporn Chuncharunee, Ponlapat Rojnuckarin, Chittima Sirijerachai, Wanchai Wanachiwanawin, Surapol Issaragrisil Adult aplastic anemia in Thailand: incidence and treatment outcome from a prospective nationwide population-based study. Annals of Hematology. Vol.100, No.10 (2021), 2443-2452. doi:10.1007/s00277-021-04566-0 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77828
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Adult aplastic anemia in Thailand: incidence and treatment outcome from a prospective nationwide population-based study
Abstract
The incidence and outcomes of aplastic anemia (AA) in Asia remain limited. This study aimed to explore the incidence and outcomes of patients with adult AA across the country of Thailand. This is a prospective multi-center nationwide population-based observational study of AA patients aged at least 15 years old, diagnosed from August 2014 to July 2016, with a longitudinal follow-up period over 2 years. There were 348 newly diagnosed adult AA patients during the enrollment period, giving an annual incidence of 4.6 per million. The incidence of severe (SAA) and very severe aplastic anemia (VSAA) (3.8 per million) was higher than non-severe AA (NSAA, 0.8 per million). The peak incidence was observed in the patients aged from 80 to 89 years old (14.4 per million). The 2-year overall survival (OS) in NSAA, SAA, and VSAA were 65.5%, 49.3%, and 20.1%, respectively (P < 0.001). With regard to the response to immunosuppressive therapy, the overall response rate (ORR) in SAA/VSAA treated with rabbit anti-thymocyte globulin with/without cyclosporin A (rATG ± CsA) were significantly superior to those treated with CsA alone, or anabolic steroids (44.4% vs 36.4% and 31.2%, respectively, P < 0.001). The 2-year OS in SAA/VSAA treated with rATG ± CsA, CsA, and anabolic steroids were 54.8%, 54.5%, and 37.6% (P = 0.037), respectively. The incidence of adult AA in Thailand is higher than those in Western countries, and the peak incidence is in the elderly. rATG ± CsA provided a better response than anabolic steroids, translating to the superior survival in SAA/VSAA treated with rATG ± CsA.
