Abstract
We describe a case of stable complete remission in a patient with refractory anemia complicated by severe autoimmune hemolytic anemia, achieved with a single high dose (4 g/m2) of cyclophosphamide (cyclo). Concomitantly, an effective mobilization of CD34-positive cells was induced. Other immunosuppressive approaches including high-dose methylprednisolone, high-dose immunoglobulin, and cyclosporine had been ineffective. This finding suggests that, in selected cases, an immunologic mechanism may mediate cytopenia in myelodysplastic syndromes (MDS). In addition, it demonstrates that successful mobilization of peripheral blood stem cells can be induced with high-dose cyclo in MDS.
MeSH terms
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Adult
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Anemia, Hemolytic, Autoimmune / complications
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Anemia, Hemolytic, Autoimmune / drug therapy
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Anemia, Hemolytic, Autoimmune / pathology
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Anemia, Hemolytic, Autoimmune / therapy
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Anemia, Refractory / complications
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Anemia, Refractory / drug therapy*
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Anemia, Refractory / pathology
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Anemia, Refractory / therapy
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Autoimmune Diseases / complications
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Autoimmune Diseases / drug therapy*
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Autoimmune Diseases / pathology
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Autoimmune Diseases / therapy
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Blood Transfusion
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Bone Marrow / pathology
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / therapeutic use*
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Cyclosporine / therapeutic use
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Hematopoietic Stem Cell Mobilization
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Humans
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Immunoglobulins, Intravenous / therapeutic use
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / therapeutic use*
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Male
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Methylprednisolone / therapeutic use
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Remission Induction
Substances
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Immunoglobulins, Intravenous
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Immunosuppressive Agents
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Cyclosporine
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Cyclophosphamide
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Methylprednisolone