Successful treatment of idiopathic pure red cell aplasia with antithymocyte globulin

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  • ATG療法が奏効した赤芽球癆
  • 症例 ATG療法が奏効した赤芽球癆
  • ショウレイ ATG リョウホウ ガ ソウコウ シタ セキガキュウロウ

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Description

An 18-year-old woman was admitted to our hospital because of severe anemia on October 16, 1999. Laboratory data included hemoglobin 3.5 g/dl, reticulocytes 2,200/μl, WBC 3,500/μl, and Plt 38.5×104/μl. Bone marrow aspiration showed a normocellular marrow with severe erythroid hypoplasia, suggesting a diagnosis of pure red cell aplasia. Methylprednisolone pulse therapy was started on October 20, but there was no response. Administration of cyclosporine A (CyA; 400∼450 mg) was begun on November 1, but again there was no response. Antithymocyte globulin (ATG; 800 mg/day for 5 days, 15 mg/kg) was started from December 1 in addition to prednisolone (60 mg/day) and CyA (450 mg/day). On day 7 of ATG therapy, the reticulocyte count began to increase, and reached a peak of 32.6×104/μl on day 20. The patient's hemoglobin level started to increase on day 13, and reached 8.5 g/dl on day 27. A complete response has been maintained up to the time of writing, and the hemoglobin level was 11.9 g/dl on December 14, 2000. This is the first detailed Japanese case report of successful treatment of pure red cell aplasia using ATG.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 42 (11), 1122-1127, 2001

    The Japanese Society of Hematology

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