Successful treatment of refractory pure red cell aplasia secondary to chronic lymphocytic leukaemia with cyclosporine A: correlation between clinical and in vitro effects.
This report presents the case of a patient with PRCA in CLL where in vitro culture studies correlated well with successful CS-A treatment. Before initiating CS-A therapy, coculture studies showed that T-cells from peripheral blood of the patient suppressed the formation of CFU-E and BFU-E colonies by normal bone marrow cells. Normal erythropoiesis reappeared in the bone marrow of the patient 3 weeks after the start of CS-A therapy. At this time, cocultures demonstrated that peripheral blood T-cells no longer inhibited the growth of normal BFU-E, although there was persistent suppression of CFU-E. Six months later the patient was in stable remission from PRCA on maintenance therapy with CS-A. Moreover, cocultures showed no T-cell inhibition of normal BFU-E or CFU-E colony formation. The strong correlation between in vitro culture studies and a beneficial clinical outcome observed in this case suggests that in vitro cultures could be used to monitor CS-A treatment in patients with PRCA in CLL.
Institute of Haematology, University Clinical Centre, Belgrade, Serbia, Yugoslavia.
M
M
Gotic
N
N
Basara
Z
Z
Rolovic
D
D
Boskovic
P
P
Antunovic
D
D
Marisavljevic
S
S
Brkic
D016572:Cyclosporine / Q000627:therapeutic use*; D004920:Erythropoiesis; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy* / Q000209:etiology; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology
D016572:Cyclosporine