Complete remission of MDS RAEB following immunosuppressive treatment in a patient with Sweet's syndrome.
We report on a patient with myelodysplastic syndrome (MDS), classified as refractory anaemia with excess of blasts-2, and histiocytoid Sweet's syndrome. The skin lesions disappeared after initiation of corticosteroids and doxycycline. Remarkably, two months later a complete remission of the MDS occurred. Fourteen months later both the skin lesions and the MDS relapsed. Antileukaemic activity following reversion of the impaired cellular immunity due to an increased number of natural killer cells in his bone marrow may be responsible for this rare event. Inhibition of T-cell mediated myelosuppression by corticosteroids or a proapoptotic effect of doxycycline may have attributed as well.
Ten Oever
J
J
Department of Internal Medicine, Máxima Medical Centre Veldhoven, Veldhoven, the Netherlands. j.tenoever@mmc.nl
Kuijper
P H M
PH
Kuijpers
A L A
AL
Dercksen
M W
MW
Vreugdenhil
G
G
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000150:complications / Q000188:drug therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007694:Killer Cells, Natural; D008297:Male; D012008:Recurrence; D012074:Remission Induction; D016463:Sweet Syndrome / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D004318:Doxycycline