title: Relapse of aplastic anemia responsive to sirolimus combined with cyclosporine.
abstract: Aplastic anemia (AA) is an immune-mediated disease. Although most patients are responsive to immunosuppressive therapy (IST) with a combination of anti-thymocyte globulin (ATG) and cyclosporine (CsA), some patients relapse or are refractory to IST. Sirolimus (rapamysin) inhibits the serine-threonine kinase mammalian target of rapamysin (mTOR), and blocks CsA-resistant and calcium-independent pathways late in the progression of the T-cell cycle. We report two cases of AA which relapsed after CsA and ATG plus CsA, respectively. They achieved transfusion independence after retreatment with sirolimus in combination with a CsA.
authors.affiliation: Key Laboratory of Thrombosis and Hematostasis of Ministry of Health, Jiangsu Insititute of Hematology, Department of Hematology of First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R. China. heguangsheng@medmail.com.cn
authors.forename: Guangsheng
authors.initials: G
authors.lastname: He
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Depei
authors.initials: D
authors.lastname: Wu
authors.forename: Aining
authors.initials: A
authors.lastname: Sun
authors.forename: Xiuli
authors.initials: X
authors.lastname: Wang
mesh_terms: D000741:Anemia, Aplastic / Q000188:drug therapy*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D012008:Recurrence; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus