@article{Hirotoshi Sakaguchi_Nobuhiro Nishio_Asahito Hama_Nozomu Kawashima_Xinan Wang_Atsushi Narita_Sayoko Doisaki_Yinyan Xu_Hideki Muramatsu_Nao Yoshida_Yoshiyuki Takahashi_Kazuko Kudo_Hiroshi Moritake_Kazuhiro Nakamura_Ryoji Kobayashi_Etsuro Ito_Hiromasa Yabe_Shouichi Ohga_Akira Ohara_Seiji Kojima_2014, place={Pavia, Italy}, title={Peripheral blood lymphocyte telomere length as a predictor of response to immunosuppressive therapy in childhood aplastic anemia}, volume={99}, url={https://haematologica.org/article/view/7110}, DOI={10.3324/haematol.2013.091165}, abstractNote={Predicting the response to immunosuppressive therapy could provide useful information to help the clinician define treatment strategies for patients with aplastic anemia. In our current study, we evaluated the relationship between telomere length of lymphocytes at diagnosis and the response to immunosuppressive therapy in 64 children with aplastic anemia, using flow fluorescence <em>in situ</em> hybridization. Median age of patients was ten years (range 1.5–16.2 years). Severity of the disease was classified as very severe in 23, severe in 21, and moderate in 20 patients. All patients were enrolled in multicenter studies using antithymocyte globulin and cyclosporine. The response rate to immunosuppressive therapy at six months was 52% (33 of 64). The probability of 5-year failure-free survival and overall survival were 56% (95% confidence interval (CI): 41–69%) and 97% (95%CI: 87–99%), respectively. Median telomere length in responders was −0.4 standard deviation (SD) (−2.7 to +3.0 SD) and −1.5 SD (−4.0 to +1.6 (SD)) in non-responders (<em>P</em><0.001). Multivariate analysis showed that telomere length shorter than −1.0 SD (hazard ratio (HR): 22.0; 95%CI: 4.19–115; <em>P</em><0.001), platelet count at diagnosis less than 25×10<sup>9</sup>/L (HR: 13.9; 95%CI: 2.00–96.1; <em>P</em>=0.008), and interval from diagnosis to immunosuppressive therapy longer than 25 days (HR: 4.81; 95%CI: 1.15–20.1; <em>P</em&gt;=0.031) were the significant variables for poor response to immunosuppressive therapy. Conversely to what has been found in adult patients, measurement of the telomere length of lymphocytes at diagnosis is a promising assay in predicting the response to immunosuppressive therapy in children with aplastic anemia.}, number={8}, journal={Haematologica}, author={Hirotoshi Sakaguchi and Nobuhiro Nishio and Asahito Hama and Nozomu Kawashima and Xinan Wang and Atsushi Narita and Sayoko Doisaki and Yinyan Xu and Hideki Muramatsu and Nao Yoshida and Yoshiyuki Takahashi and Kazuko Kudo and Hiroshi Moritake and Kazuhiro Nakamura and Ryoji Kobayashi and Etsuro Ito and Hiromasa Yabe and Shouichi Ohga and Akira Ohara and Seiji Kojima}, year={2014}, month={Jul.}, pages={1312-1316} }