title: Ticlopidine-induced aplastic anemia: development of chromosomal abnormalities and response to immunosuppressive therapy.
abstract: Severe aplastic anemia is a well-recognized complication of ticlopidine therapy that carries a high mortality. Therapy with colony-stimulating factors or corticosteroids has been largely ineffective in this disorder. We report a case of ticlopidine-induced aplastic anemia that was successfully treated with cyclosporine and high-dose dexamethasone. The patient rapidly responded to immunosuppressive therapy and had a normal hemogram after cessation of immunosuppression. On long-term follow-up, the patient developed a progressive macrocytic anemia. Repeat bone marrow evaluation demonstrated myelodysplasia with erythroid hypoplasia. An associated chromosomal abnormality consisting of a t(3;16) (q21; p13.3) translocation was detected. This is the first report of a chromosomal abnormality associated with ticlopidine induced marrow aplastic anemia.
authors.affiliation: The Division of Hematology, Department of Medicine, The University of Southern California School of Medicine, Los Angeles, California, USA.
authors.forename: V A
authors.initials: VA
authors.lastname: Pullarkat
authors.forename: H
authors.initials: H
authors.lastname: Rho
authors.forename: J L
authors.initials: JL
authors.lastname: Murata-Collins
authors.forename: H A
authors.initials: HA
authors.lastname: Liebman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000741:Anemia, Aplastic / Q000139:chemically induced* / Q000188:drug therapy* / Q000235:genetics; D001853:Bone Marrow / Q000187:drug effects*; D002869:Chromosome Aberrations / Q000139:chemically induced* / Q000188:drug therapy*; D025063:Chromosome Disorders; D016572:Cyclosporine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D013988:Ticlopidine / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D003907:Dexamethasone; D016572:Cyclosporine; D013988:Ticlopidine