Complete response to tacrolimus in a child with severe aplastic anemia resistant to cyclosporin A.
Aplastic anemia (AA) is a rare disorder in children, usually treated with immunosuppressive therapy (IST) including antithymocyte globulin (ATG) and cyclosporin A. There are no current widely used alternative therapies with comparable efficacy. We describe a child with severe aplastic anemia (SAA), who developed severe gingival hyperplasia secondary to cyclosporin A, unresponsive to intensive dental intervention. When IST was changed to tacrolimus there was a significant improvement in the gingival hyperplasia, but equally important, he achieved complete response of his AA within several months. The use of tacrolimus in children with AA may be a potential modality of treatment.
Macartney
Christine
C
Marrow Failure and Myelodysplasia Program, Division of Haematology and Oncology, Department of Paediatrics, The Hospital for Sick Children, and The University of Toronto, Toronto, Ontario, Canada.
Freilich
Marshall
M
Odame
Isaac
I
Charpentier
Karen
K
Dror
Yigal
Y
D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000503:physiopathology; D000753:Anemia, Refractory / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D016572:Cyclosporine / Q000009:adverse effects*; D005885:Gingival Hyperplasia / Q000139:chemically induced; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D016559:Tacrolimus / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus