Cyclosporine-responsive thrombocytopenia in a patient with chloramphenicol-associated myelodysplastic syndrome.
A 64-yr-old patient with myelodysplastic syndrome (MDS), with refractory cytopenia with multilineage dysplasia subtype following chloramphenicol exposure received immunosuppressive treatment with antithymocyte globulin and cyclosporine (CsA). Complete remission was achieved and CsA was tapered after 2.5 yr. Shortly after CsA withdrawal, the patient relapsed with thrombocytopenia but responded to restoration of CsA. This case illustrates that immune-mediated mechanisms of cytopenia in MDS may be dependent on continued immunosuppressive treatment similar to aplastic anemia.
Arber
Caroline
C
Hematology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.
Buser
Andreas
A
Heim
Dominik
D
Gratwohl
Alois
A
Tichelli
André
A
Passweg
Jakob R
JR
D002701:Chloramphenicol / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D010198:Pancytopenia / Q000276:immunology; D010976:Platelet Count; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000209:etiology
D007166:Immunosuppressive Agents; D002701:Chloramphenicol; D016572:Cyclosporine