title: Cyclosporin-A therapy of pure red cell aplasia in a patient with B-cell chronic lymphocytic leukemia.
abstract: A 65-year-old woman with B-cell chronic lymphocytic leukemia (CLL) and pure red cell aplasia (PRCA) is described. After initial chemotherapy with three different regimens over 3 months (prednisone, chlorambucil/vincristine, cyclophosphamide, bleomycin/cyclophosphamide, etoposide, prednisone), normalization of the blood lymphocyte count was observed, but lymphocyte infiltration of the bone marrow persisted and erythropoiesis remained virtually absent. Monotherapy with cyclosporin-A (CyA) was begun. After 35 days, a marked increase in the reticulocyte count was observed, and with continuing therapy, there was a rapid increase in the hemoglobin level. Follow-up after 13 months of uninterrupted treatment with CyA revealed remission of both CLL and PRCA. CyA should be investigated further as a therapeutic modality for PRCA in patients with CLL, and such trials might provide further clues to the pathogenesis of this peculiar association.
authors.affiliation: Department of Medicine, University Hospital, Zürich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Christen
authors.forename: R
authors.initials: R
authors.lastname: Morant
authors.forename: J
authors.initials: J
authors.lastname: Fehr
mesh_terms: D000368:Aged; D003524:Cyclosporins / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy*
chemical_list: D003524:Cyclosporins