Therapeutic effect of cyclosporine A in thrombocytopenia after myeloablative chemotherapy in acute myeloid leukaemia.
Four patients with acute myelogenous leukaemia (AML), who developed isolated thrombocytopenia after anti-leukaemic chemotherapy, were treated with cyclosporine A and showed significantly enhanced platelet recovery. All four patients demonstrated decreased bone marrow megakaryocytes without dysplastic features, absence of identifiable peripheral autoimmune platelet destruction or cytogenetic evidence of secondary myelodysplasia. The duration of response to cyclosporine A ranged from 6 days to 40 months. The mechanism of cyclosporine A-induced platelet recovery may include inhibition of negative modulators and induction of thrombopoietic cytokines mediated by bone marrow regulatory cells.
Novik
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Albert Einstein Cancer Center, Department of Oncology, Montefiore Medical Center, Bronx, New York 10467, USA.
Oleksowicz
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Wiernik
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PH
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy*; D019172:Transplantation Conditioning
D007166:Immunosuppressive Agents; D016572:Cyclosporine