[Effective treatment combining antithymocyte globulin, cyclosporin A, and granulocyte colony-stimulating factor for atypical paroxysmal nocturnal hemoglobinuria accompanied by bone marrow hypoplasia].
A 25-year-old man was admitted for evaluation of pancytopenia on May 2, 1997. On admission, he had pancytopenia with a normal reticulocyte count. Bone marrow aspirate specimens displayed a normal karyotype and hypocellularity without myelodysplasia. Although total bilirubin and lactate dehydrogenase levels were within their normal ranges, the haptoglobin level was low; additionally, two-color flow cytometric analysis determined that 3.3% of erythrocytes were double-negative for CD55 and CD59 expression. Atypical paroxysmal nocturnal hemoglobinuria with bone marrow hypoplasia was diagnosed. Because initial treatment with cyclosporin A was not effective, the patient was subsequently given a combination of antithymocyte globulin, cyclosporin A, and granulocyte colony-stimulating factor. Although the pancytopenia subsided, the percentage of double-negative erythrocytes in the patient's blood remained almost unchanged compared to findings obtained on admission.
Noji
H
H
First Department of Internal Medicine, Fukushima Medical University.
Shichishima
T
T
Ishikawa
S
S
Kai
T
T
Saitoh
Y
Y
Maruyama
Y
Y
D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000150:complications* / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006457:Hemoglobinuria, Paroxysmal / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine