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Myelodysplastic syndrome complicated by autoimmune hemolytic anemia: remission of refractory anemia following mycophenolate mofetil.

Abstract
Autoimmune hemolytic anemia (AIHA) rarely occurs in myelodysplastic syndrome (MDS). A 36-year-old Asian female was diagnosed with MDS (refractory cytopenia with multilineage dysplasia, RCMD) and complicated by AIHA 7 months later. Secondary myelofibrosis developed at the same time. Steroid therapy was ineffective and cyclosporin A (CsA) was discontinued due to its neurotoxicity with the development of leukoencephalopathy. However, the patient achieved a good hematological response after the use of mycophenolate mofetil (MMF, CellCept) with a dose of 1 g/day and prednisolone (15 mg/day). Prednisolone was tapered off over the next 3 weeks. The patient did not require any blood support 4 weeks after the use of MMF and has been hematologically stable for 4 months. To our knowledge, this is the first report of using MMF in treating MDS complicated by AIHA. MMF might be considered as a salvage therapy for patients with refractory anemia complicated by AIHA.
AuthorsJ-T Lin, W-S Wang, C-C Yen, T-J Chiou, J-H Liu, L-T Hsiao, M-H Yang, T-C Chao, C-J Tai, P-M Chen
JournalAnnals of hematology (Ann Hematol) Vol. 81 Issue 12 Pg. 723-6 (Dec 2002) ISSN: 0939-5555 [Print] Germany
PMID12483369 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Prednisolone
  • Mycophenolic Acid
Topics
  • Adult
  • Anemia, Hemolytic, Autoimmune (drug therapy, etiology)
  • Anemia, Refractory (drug therapy, etiology)
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
  • Female
  • Humans
  • Mycophenolic Acid (administration & dosage, analogs & derivatives)
  • Myelodysplastic Syndromes (complications, drug therapy)
  • Prednisolone (administration & dosage)
  • Primary Myelofibrosis (etiology)
  • Remission Induction (methods)
  • Salvage Therapy

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