Cyclosporin A for the treatment of cytopenia associated with chronic lymphocytic leukemia.

摘要: BACKGROUND Autoimmune cytopenias are a frequent complication in patients with chronic lymphocytic leukemia (CLL). Anecdotal reports suggest that cyclosporin A (CsA) may be beneficial for CLL-associated pure red cell aplasia. In the current study, authors investigated use of CsA management anemia or thrombocytopenia presumed autoimmune etiology associated CLL. METHODS Thirty-one CLL and were treated at dose 300 mg/day. Sixteen (52%) had (hemoglobin ≤ 11 g/dL) 29 (94%) (platelet count 100 × 109/L). Seventeen (55%) cytopenia developed during course treatment fludarabine-based regimens. Nineteen (61%) received prior therapy this using steroids, intravenous immunoglobulin, and/or splenectomy. RESULTS Eighteen (62%) 10 (63%) major response defined as an increase platelet ≥ 50 109/L hemoglobin 3 g/dL. The median time to initial was weeks (range, 1–13 weeks) best 10.5 1–48 weeks). duration months 1+–39+ months). Three fludarabine-associated able receive further fludarabine lesser decrease count. modest tumor burden observed six patients. most common toxicity Grade 2 (according National Cancer Institute's Common Toxicity Criteria) elevation creatinine, which 6 (19%). opportunistic infections. CONCLUSIONS CsA is effective alternative suspected etiology, including those cases occurring fludarabine. antileukemic effect some 2001;92:2016–22. © 2001 American Society.