Myelodysplastic syndrome complicated by autoimmune hemolytic anemia: remission of refractory anemia following mycophenolate mofetil.
Autoimmune hemolytic anemia (AIHA) rarely occurs in myelodysplastic syndrome (MDS). A 36-year-old Asian female was diagnosed with MDS (refractory cytopenia with multilineage dysplasia, RCMD) and complicated by AIHA 7 months later. Secondary myelofibrosis developed at the same time. Steroid therapy was ineffective and cyclosporin A (CsA) was discontinued due to its neurotoxicity with the development of leukoencephalopathy. However, the patient achieved a good hematological response after the use of mycophenolate mofetil (MMF, CellCept) with a dose of 1 g/day and prednisolone (15 mg/day). Prednisolone was tapered off over the next 3 weeks. The patient did not require any blood support 4 weeks after the use of MMF and has been hematologically stable for 4 months. To our knowledge, this is the first report of using MMF in treating MDS complicated by AIHA. MMF might be considered as a salvage therapy for patients with refractory anemia complicated by AIHA.
Lin
J-T
JT
Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, #201, Sec. 2, Shi-Pai Road, Taiwan.
Wang
W-S
WS
Yen
C-C
CC
Chiou
T-J
TJ
Liu
J-H
JH
Hsiao
L-T
LT
Yang
M-H
MH
Chao
T-C
TC
Tai
C-J
CJ
Chen
P-M
PM
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy* / Q000209:etiology; D000753:Anemia, Refractory / Q000188:drug therapy / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009173:Mycophenolic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage; D055728:Primary Myelofibrosis / Q000209:etiology; D012074:Remission Induction / Q000379:methods; D016879:Salvage Therapy
D011239:Prednisolone; D009173:Mycophenolic Acid