Long-lasting effect of cyclosporin-A on anemia associated with idiopathic myelofibrosis.
Some reports suggest that immunologic mechanisms may play a role in the pathogenesis of anemia in idiopathic myelofibrosis (IMF). Herein we report the case of a transfusion dependent IMF patient with psoriasis in whom cyclosporin-A (CyA) treatment for skin lesions (200 mg/day) was associated with long-lasting correction of anemia. After 2 months of CyA therapy the patient's Hb level increased and he became transfusion free in 4 months. After 12 months immunosuppressive therapy was discontinued due to renal toxicity, yet the Hb level remained stable for an additional 12 months. The patient is currently being administered CyA at a reduced dosage because of mild renal impairment along with transfusional support consisting of a median of 2 red cell units/month. Altogether the patient received no transfusional support for 36 months. This case, as well as other reports, suggests that the issue of immunosuppressive treatment in IMF anemia deserves further investigation.
Pietrasanta
D
D
Chair of Hematology DIMI, University of Genoa, Italy.
Clavio
M
M
Vallebella
E
E
Beltrami
G
G
Cavaliere
M
M
Gobbi
M
M
D000368:Aged; D000740:Anemia / Q000150:complications / Q000188:drug therapy; D016572:Cyclosporine / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D055728:Primary Myelofibrosis / Q000150:complications / Q000188:drug therapy; D013997:Time Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine