Immunosuppressive treatment in patient with pure red cell aplasia associated with chronic myelomonocytic leukemia: Harm or benefit?

Saloni Tanna, Celalettin Ustun

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Acquired pure red cell aplasia (PRCA) can be primary or secondary to other diseases. PRCA association with chronic myelomonocytic leukemia (CMML) is very rarely reported. Although treatment is directed to underlying cause in secondary PRCA treatment, optimal treatment in patients with CMML and PRCA is unknown, because only four case reports are available. In addition, the effect of hypomethylating agents can be detrimental due to myelosuppression, at least in the early phase of treatment. Bone marrow examination of a 66-year-old woman with severe anemia revealed PRCA and was suspicious for CMML. There was no HLA-matched sibling for bone marrow transplantation. The patient received immunosuppressive therapy with steroids and cyclosporine with temporary response in anemia; however, progressed to acute leukemia over 8 months and died. Immunosuppressive therapy in patients with CMML and PRCA should be cautiously used because it may accelerate acute leukemia transformation.

Original languageEnglish (US)
Pages (from-to)597-600
Number of pages4
JournalInternational Journal of Hematology
Volume90
Issue number5
DOIs
StatePublished - Dec 1 2009

Keywords

  • Acute myelogenous leukemia
  • Chronic myelomonocytic leukemia
  • Immunosuppressive treatment
  • Pure red cell aplasia

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