title: [Successful treatment with azathioprine for autoimmune thrombocytopenia developing after autologous peripheral blood stem cell transplantation].
abstract: A 60-year-old man with acute promyelocytic leukemia in complete remission had minimal residual disease (MRD). After two courses of arsenic trioxide treatment, the MRD disappeared. In October 2005, he received an unmanipulated autologous peripheral blood stem cell transplantation (autoPBSCT). Hematologic recovery was prompt; however, after day 21 following the autoPBSCT, platelet counts decreased to below 10 x 10(9)/l. A bone marrow aspirate showed an increased number of immature megakaryocytes, and platelet-associated IgG was elevated to 48.5 ng/10(7) platelets. A diagnosis of autoimmune thrombocytopenia was made. The combination of oral prednisolone (40 mg/day) and bolus immunoglobulin infusion (400 mg/kg, for 5 consecutive days) was ineffective. He was given azathioprine (50 mg/day, orally), and 10 days after the initiation of the treatment, the platelet counts gradually increased and recovered to over 50 x 10(9)/l on day 168, and 100 x 10(9)/l on day 364. To the best of our knowledge, successful treatment of ITP following auto PBSCT with azathioprine has not been previously reported.
authors.affiliation: Department of Hematology, Institute for Biomedical Research Innovation.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Fujita
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Togami
authors.forename: Minako
authors.initials: M
authors.lastname: Mori
authors.forename: Hisako
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagai
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nagai
authors.forename: Sumie
authors.initials: S
authors.lastname: Tabata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurata
authors.forename: Akiko
authors.initials: A
authors.lastname: Mastusita
authors.forename: Akinori
authors.initials: A
authors.lastname: Maeda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine