Abstract：Objective To detect the expression of CD55 and CD59 on red blood cells and granulocytes in peripheral blood of patients with chronic aplastic anemia(CAA),and to explore its relationship to the efficacy and prognosis of cyclosporine A(CsA) treatment.Methods The expression of CD55 and CD59 was detected in 67 CAA patients and 30 normal subjects using fluorescein-labeled anti-CD55 and anti-CD59 monoclonal antibodies by flow cytometry.These patients were divided into group A and group B according to whether patients had paroxysmal nocturnal hemoglobinuria(PNH)-type CD55-CD59-peripheral erythrocytes and/or neutrophils.All patients were treated with CsA for more than 6 months and were followed up.Results The percentage of PNH-type cells was less than 3.0% and 3.0% to 10.0% in all normal subjects and 57 CAA patients,respectively.The median follow-up time was 28.2 months(range 17.0-51.4 months).The onset time of CsA effect,effective rate,recurrence rate,3-year overall survival rate and 1-year disease-free survival rate were,respectively,(5.18±2.53)months,87.7%(50/57),10.0%(5/50),100.0% and 43.9%(25/57) in group A,and(10.67±1.15)months,30.0%(3/10),66.7%(2/3),44.4% and 10.0%(1/10) in group B.The differences were significant between the two groups(P<0.001 or P<0.05).Conclusion The PNH-type erythrocytes and/or neutrophils are present in patients with CAA at low levels.Compared with patients without PNH-type cells,CsA treatment sensitivity,effective rate,3-year overall survival rate and 1-year disease-free survival rate increase and recurrence rate decreases in patients with PNH-type cells.These results will contribute to medication guidance and prognosis prediction in patients with CAA.
2012, Vol. 52 
