Successful treatment of pure red cell aplasia with cyclosporin A and erythropoietin after thymectomy in a 88-year old woman.

Toyoki Maeda, Satoshi Shiokawa, Yasuji Yoshikawa, Takashi Hiroyama, Yasuhiro Nakashima, Hiromi Muta, Masaharu Nakayama, Yukoh Nakazaki, Shinichiro Akizuki, Kanako Shimizu, Toshitaka Mutoh, Shinichi Somada, Ryo Kurita, Motoaki Shiratsuchi, Naoki Makino, Junji Nishimura, Kenzaburo Tani

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Abstract

An 88-year old Japanese female with pure red cell aplasia was treated safely and effectively by a combination of thymectomy, cyclosporin A, and erythropoietin. The thymoma was histologically classified as lymphocytic type or cortical type, which are uncommon in cases of a thymoma accompanied by pure red cell aplasia. Immunohistochemical analysis of the thymoma and bone marrow revealed a predominance of CD8(+) cells. Thymectomy alone was ineffective, but cyclosporin A treatment subsequent to thymectomy was safe and effective and resulted in the disappearance of a Vbeta12 bearing T-cell clone in the bone marrow. Additional treatment with erythropoietin enhanced the effects of cyclosporin A and restored the patient's hemoglobin to normal levels. The beneficial effect of cyclosporin A may be attributed not to a broad immunomodulatory effect, but to a local effect on a limited T-cell subset.

Original languageEnglish
JournalHaematologica
Volume89
Issue number6 Suppl
Publication statusPublished - Jan 1 2004
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology

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    Maeda, T., Shiokawa, S., Yoshikawa, Y., Hiroyama, T., Nakashima, Y., Muta, H., Nakayama, M., Nakazaki, Y., Akizuki, S., Shimizu, K., Mutoh, T., Somada, S., Kurita, R., Shiratsuchi, M., Makino, N., Nishimura, J., & Tani, K. (2004). Successful treatment of pure red cell aplasia with cyclosporin A and erythropoietin after thymectomy in a 88-year old woman. Haematologica, 89(6 Suppl).