Successful treatment with cyclosporine of thymoma-related aplastic anemia.
Aplastic anemia is a rare immune-mediated complication of thymoma. Thymomas, especially of the cortical type, have the capacity to generate mature T-cells from their immature precursors. Furthermore, mature intratumorous T-cells have an increased autoantigen-specific potential. We present the case of a 75-year-old patient with an inoperable cortical thymoma who developed aplastic anemia 7 years after the initial diagnosis. The infiltration of the bone marrow by these cells was accompanied by the production of cytokines such as tumor necrosis factor alpha (TNF-alpha) in the microenvironment of bone marrow and in the serum sample. The patient was successfully treated with oral cyclosporine A for 14 months and when she died due to progression of the thymoma, 9 months after the discontinuation of cyclosporine, the aplastic anemia had not recurred.
Gaglia
A
A
Second Department of Internal Medicine-Propaedeutic, Oncology Section, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece. gagliam2000@hotmail.com
Bobota
A
A
Pectasides
E
E
Kosmas
C
C
Papaxoinis
G
G
Pectasides
D
D
D000368:Aged; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000209:etiology* / Q000276:immunology; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D013945:Thymoma / Q000097:blood / Q000150:complications* / Q000276:immunology
D007166:Immunosuppressive Agents; D016572:Cyclosporine