Thymoma-associated pancytopenia: effectiveness of cyclosporine A.
Aplastic anemia is a rare complication of thymoma and is properly documented in only few cases. Here, we report the case of a previously healthy, 65-year-old patient who was found simultaneously to have a spindle-cell thymoma and severe hypoplastic anemia with a mild infiltration of the bone marrow by CD4+ and CD8+ T lymphocytes, CD16+ natural killer cells, and a decrease in blood CD4/CD8 ratio. Cultures of marrow erythroid progenitors demonstrated serum inhibitor. While steroids, cyclophosphamide and antilymphocyte globulin failed to improve hematopoiesis, cyclosporine A (Cy-A) led to a partial, stable remission that was sustained for 4 years. Since Cy-A has been associated with good responses in three cases of thymoma-associated red cell aplasia, we recommend its use in cases of thymoma-associated cytopenias refractory to steroids and cyclophosphamide.
Liozon
E
E
Service de Médecine Interne A, CHRU Dupuytren, Limoges, France.
Touati
M
M
Allegraud
A
A
Gachard
N
N
Loustaud
V
V
Vidal
E
E
Bordessoule
D
D
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D010198:Pancytopenia / Q000150:complications*; D019233:Retreatment; D013945:Thymoma / Q000150:complications / Q000188:drug therapy*; D013953:Thymus Neoplasms / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide