title: [Hematologic improvement with deferasirox following tandem antithymocyte globulin treatment in a transfusion-dependent patient with severe aplastic anemia].
abstract: A 62-year-old man with transfusion-dependent severe aplastic anemia received immunosuppressive therapy (IST) with rabbit antithymocyte globulin and cyclosporine A in April 2010. However, his transfusion dependency did not improve. As more than 100 red blood cell (RBC) transfusions had been performed, he was administered iron chelation therapy (ICT) with deferasirox (DFX) to improve iron overload starting in July 2011. Consequently, both RBC and platelet transfusion dependency gradually improved concomitant with a decrease in serum ferritin. The bone marrow (BM) biopsy findings before administration of DFX showed severe iron accumulation and strong positive immunostaining for 8-OHdG, a marker of oxidative stress due to free iron. One year after ICT, the number of BM hematopoietic cells was increased and both iron deposition and oxidative stress were decreased. These findings suggest that DFX may contribute to hematological improvement in patients with IST-refractory aplastic anemia.
authors.affiliation: Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
authors.forename: Wataru
authors.initials: W
authors.lastname: Jomen
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsuno
authors.forename: Masanori
authors.initials: M
authors.lastname: Sato
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.forename: Tamaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujii
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Miri
authors.initials: M
authors.lastname: Fujita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nagashima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iyama
authors.forename: Koji
authors.initials: K
authors.lastname: Miyanishi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobune
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000741:Anemia, Aplastic / Q000209:etiology / Q000628:therapy*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000379:methods; D016572:Cyclosporine / Q000627:therapeutic use; D000077588:Deferasirox; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000961:Antilymphocyte Serum; D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D016572:Cyclosporine; D000077588:Deferasirox