1.10 Prognosis
Main goal of treatment is to improve life expectancy, durable haematological response to reduce risk of relapse or clonal evolution (165).
Haemopoietic response of the patients taking IST is up to 74% with long term survival rate of about 90% while 20-40% responders show a relapse (166). Various factors are believed to have a prognostic value including younger age, male gender, early start of treatment after diagnosis, low TLC, high absolute neutrophil counts and high retic count (166). Response rate of IST is about 60-80% with 5-year survival is 55-80%. Haematological response is generally seen after atleast 4 months of treatment (167).
1.10.1 Response criteria:
Following criteria is required to define whether the response …show more content…
Majority of T lymphocyte subsets comprises of CD4 (helper cells) and CD8 (cytotoxic cells) cells. CD4 and CD8 cells play their role in cell mediated immunity in normal patients which is very vital to prevent against various diseases. Raised absolute counts of CD4 and CD8 cells and altered.
CD4/CD8 ratio is proven to be the underlying aetiology in autoimmune diseases. Various countries have tried to establish their own normal reference ranges for different haematological parameter including CD4 and CD8 cell counts and ratio. Table 1.3 shows the results of some studies done on normal individuals of different ages and socioeconomic status. All the results do not show very remarkable differences however, there is difference in the ranges which might be important while assessing the response or diagnosis of autoimmune diseases.
Table 1.3. Comparison of mean ± SD values of CD4, CD8 lymphocytes and CD4/CD8 ratio in normal individuals reported for different populations across the world.
S. No No of participants Target population Country of study CD4
(Mean± SD) …show more content…
As it is known from previous studies, that the counts and ratios of T cells particularly CD4 and CD8 cells is disturbed which are then responsible for immune mediated destruction of haemopoietic stem cells. Immunosuppressive drugs are used worldwide as treatment option where HSCT is either unavailable or unaffordable. ATG is also used as immunosuppressive drug of choice in developed countries but due to its high cost, it is not a favourable option in developing countries. Cyclosporine, either used alone or in combination with Oxymetholone is a widely used immunosuppressive drug and very effective as treatment of aplastic anaemia. In developing countries like Pakistan, where treatment options are limited, Tacrolimus is used as immunosuppressive therapy in patients not responding or intolerant to Cyclosporine alone or with
Main goal of treatment is to improve life expectancy, durable haematological response to reduce risk of relapse or clonal evolution (165).
Haemopoietic response of the patients taking IST is up to 74% with long term survival rate of about 90% while 20-40% responders show a relapse (166). Various factors are believed to have a prognostic value including younger age, male gender, early start of treatment after diagnosis, low TLC, high absolute neutrophil counts and high retic count (166). Response rate of IST is about 60-80% with 5-year survival is 55-80%. Haematological response is generally seen after atleast 4 months of treatment (167).
1.10.1 Response criteria:
Following criteria is required to define whether the response …show more content…
Majority of T lymphocyte subsets comprises of CD4 (helper cells) and CD8 (cytotoxic cells) cells. CD4 and CD8 cells play their role in cell mediated immunity in normal patients which is very vital to prevent against various diseases. Raised absolute counts of CD4 and CD8 cells and altered.
CD4/CD8 ratio is proven to be the underlying aetiology in autoimmune diseases. Various countries have tried to establish their own normal reference ranges for different haematological parameter including CD4 and CD8 cell counts and ratio. Table 1.3 shows the results of some studies done on normal individuals of different ages and socioeconomic status. All the results do not show very remarkable differences however, there is difference in the ranges which might be important while assessing the response or diagnosis of autoimmune diseases.
Table 1.3. Comparison of mean ± SD values of CD4, CD8 lymphocytes and CD4/CD8 ratio in normal individuals reported for different populations across the world.
S. No No of participants Target population Country of study CD4
(Mean± SD) …show more content…
As it is known from previous studies, that the counts and ratios of T cells particularly CD4 and CD8 cells is disturbed which are then responsible for immune mediated destruction of haemopoietic stem cells. Immunosuppressive drugs are used worldwide as treatment option where HSCT is either unavailable or unaffordable. ATG is also used as immunosuppressive drug of choice in developed countries but due to its high cost, it is not a favourable option in developing countries. Cyclosporine, either used alone or in combination with Oxymetholone is a widely used immunosuppressive drug and very effective as treatment of aplastic anaemia. In developing countries like Pakistan, where treatment options are limited, Tacrolimus is used as immunosuppressive therapy in patients not responding or intolerant to Cyclosporine alone or with