The evaluation of acquired aplastic anemia in children and unexpected frequency of varicella-zoster virus association: A single-center study

In this study, 32 patients under the age of 17 years with acquired aplastic anemia (AAA) were evaluated. Nine patients developed AAA associated with viral infection in which viral hepatitis and varicella infection were nearly equal. Four of the patients were administered drugs before developing AAA. Patients were treated as follows: combined immunosuppressive therapy (CIST) including anti-thymocyte or anti-lymphocyte globulin plus high-dose methylprednisolone (HDMP) and cyclosporin A and granulocyte colony-stimulating factor (G-CSF) (14 patients); mega-dose (30 mg/kg) methylprednisolone (8 patients); and HDMP combined with cyclosporin A or anapolon or cyclophosphamide (6 patients). Complete remission was seen in 10 patients and partial remission in 2 patients. The response rate was similar in the CIST and MDMP groups. The most striking findings of this study were the frequent association of AAA with varicella infection and the low cure rate, which was due to patient non-compliance with the treatment and inadequate isolation conditions in the hospital.