Successful Treatment of Acquired Amegakaryocytic Thrombocytopenic Purpura Refractory to Corticosteroids and Intravenous Immunoglobulin with Antithymocyte Globulin and Cyclosporin

Overview

Journal Int J Hematol

Specialty Hematology

Date 2008 Jul 16

PMID 18626728

Citations 5

Authors

Pimjai Niparuck

Vichai Atichartakarn

Suporn Chuncharunee

Affiliations

Soon will be listed here.

Abstract

Four patients with acquired amegakaryocytic thrombocytopenic purpura, who had failed corticosteroids, intravenous immunoglobulin and cyclophosphamide therapy, were treated with antithymocyte globulin, followed by cyclosporin. Three patients achieved complete remission in 28-178 days and the response duration was 16-60 months from the beginning of treatment. One patient achieved a partial response for 2 months followed by myelodysplastic syndrome 5 months later. He died in 9 months due to intracerebral bleeding. Marrow cytogenetics showed 47, XY, +21.

Citing Articles

Anti Thymocyte Globulin-Based Treatment for Acquired Bone Marrow Failure in Adults.

Tjon J, Langemeijer S, Halkes C Cells. 2021; 10(11).

PMID: 34831130 PMC: 8616121. DOI: 10.3390/cells10112905.

Marked rebound thrombocytosis in response to glucocorticoids in a patient with acquired amegakaryocytic thrombocytopenia.

Nishino S, Kodaka T, Sawada Y, Goka T, Gotoh Y, Tsunemine H J Clin Exp Hematop. 2018; 58(4):166-170.

PMID: 30416171 PMC: 6407476. DOI: 10.3960/jslrt.18016.

Acquired Amegakaryocytic Thrombocytopenia and Pure Red Cell Aplasia in Thymoma.

Dahal S, Sharma E, Dahal S, Shrestha B, Bhattarai B Case Rep Hematol. 2018; 2018:5034741.

PMID: 29713553 PMC: 5866878. DOI: 10.1155/2018/5034741.

Anti-CD20 Antibody is Effective in the Patient with Refractory Amegakaryocytic Thrombocytopenia, 25 Months Follow up.

Mirzania M, Khalili S, Hasanpoor A, Shamshiri A Int J Hematol Oncol Stem Cell Res. 2014; 8(2):41-4.

PMID: 24800039 PMC: 4003443.

"Almost bleeding to death": the conundrum of acquired amegakaryocytic thrombocytopenia.

Brown G, Babiker H, Cantu C, Yeager A, Krishnadasan R Case Rep Hematol. 2014; 2014:806541.

PMID: 24649385 PMC: 3932838. DOI: 10.1155/2014/806541.

References

Hoffman R, Bruno E, Elwell J, Mazur E, Gewirtz A, Dekker P . Acquired amegakaryocytic thrombocytopenic purpura: a syndrome of diverse etiologies. Blood. 1982; 60(5):1173-8. View

Hirsh E, VOGLER W, McDONALD T, Stein S . Acquired hypomegakaryocytic thrombocytopenic purpura. Occurrence in a patient with absent thrombopoietic stimulating factor. Arch Intern Med. 1980; 140(5):721-3. DOI: 10.1001/archinte.140.5.721. View

Griner P, HOYER L . Amegakaryocytic thrombocytopenia in systemic lupus erythematosus. Arch Intern Med. 1970; 125(2):328-32. View

Erkurt M, Kaya E, Baran M, Yitmen E, Senel S, Kuku I . Rapid progression of acquired amegakaryocytic thrombocytopenia to myelodysplastic syndrome: case report. Turk J Haematol. 2016; 22(4):205-8. View

Hoffman R . Acquired pure amegakaryocytic thrombocytopenic purpura. Semin Hematol. 1991; 28(4):303-12. View

El Omri H, Skouri H, Kraiem I, Latiri A, Khelif A, Korbi S . [Acquired amegakaryocytic thrombocytopenic purpura treated with intravenous immunoglobulins]. Ann Med Interne (Paris). 2000; 151(3):223-6. View

Harjai K, Shah M, Pant A, Kale P, Pathare A . Amegakaryocytic thrombocytopenic purpura. J Postgrad Med. 1992; 38(2):96-7. View

Kashyap R, Choudhry V, Pati H . Danazol therapy in cyclic acquired amegakaryocytic thrombocytopenic purpura: a case report. Am J Hematol. 1999; 60(3):225-8. DOI: 10.1002/(sici)1096-8652(199903)60:3<225::aid-ajh10>3.0.co;2-s. View

Lonial S, Bilodeau P, Langston A, Lewis C, HOLDEN J, Waller E . Acquired amegakaryocytic thrombocytopenia treated with allogeneic BMT: a case report and review of the literature. Bone Marrow Transplant. 2000; 24(12):1337-41. DOI: 10.1038/sj.bmt.1702063. View

10.

Felderbauer P, Ritter P, Mattern D, Schmitz F, Bulut K, Ansorge N . Acquired pure megakaryocytic aplasia: a separate haematological disease entity or a syndrome with multiple causes?. Eur J Haematol. 2004; 72(6):451-4. DOI: 10.1111/j.1600-0609.2004.00241.x. View

11.

Trimble M, GLYNN M, Brain M . Amegakaryocytic thrombocytopenia of 4 years duration: successful treatment with antithymocyte globulin. Am J Hematol. 1991; 37(2):126-7. DOI: 10.1002/ajh.2830370212. View

12.

Ghosh K, Sarode R, Varma N, Varma S, Garewal G . Amegakaryocytic thrombocytopenia of nutritional vitamin B12 deficiency. Trop Geogr Med. 1988; 40(2):158-60. View

13.

Nagasawa T, Sakurai T, Kashiwagi H, Abe T . Cell-mediated amegakaryocytic thrombocytopenia associated with systemic lupus erythematosus. Blood. 1986; 67(2):479-83. View

14.

Hill W, Landgraf R . Successful treatment of amegakaryocytic thrombocytopenic purpura with cyclosporine. N Engl J Med. 1985; 312(16):1060-1. View

15.

Benedetti F, de Sabata D, Perona G . T suppressor activated lymphocytes (CD8+/DR+) inhibit megakaryocyte progenitor cell differentiation in a case of acquired amegakaryocytic thrombocytopenic purpura. Stem Cells. 1994; 12(2):205-13. DOI: 10.1002/stem.5530120209. View

16.

El Saghir N, Geltman R . Treatment of acquired amegakaryocytic thrombocytopenic purpura with cyclophosphamide. Am J Med. 1986; 81(1):139-42. DOI: 10.1016/0002-9343(86)90197-x. View

17.

Rovira M, Feliu E, Florensa L, WOESSNER S, Tassies D, Montserrat E . Acquired amegakaryocytic thrombocytopenic purpura associated with immunoglobulin deficiency. Acta Haematol. 1991; 85(1):34-6. DOI: 10.1159/000204849. View