FIRST REPORT OF A B-CELL LYMPHOPROLIFERATIVE DISORDER ARISING IN A PATIENT TREATED WITH IMMUNE SUPPRESSANTS FOR SEVERE APLASTIC-ANEMIA

Aplastic anemia is a disorder characterized by pancytopenia and bone m arrow hypocellularity, There is some evidence that aplastic anemia may be due to suppression of hematopoiesis by activated T-suppressor cell s, Thus, immunosuppressive agents have been used as an alternative to bone marrow transplantation for treatment, We report on a unique case of a patient with aplastic anemia who was treated with a course of imm unosuppression including cyclosporine (CSA), anti-thymocyte globulin ( ATG), and prednisone. Five months after this treatment, the patient de veloped a B cell lymphoproliferative disorder which was successfully t reated with radiation therapy, Prior reports of CSA-associated lymphop roliferative disorders have appeared in the literature as potential si de effects of immunosuppression following transplantation. This is the first report of a lymphoproliferative disorder associated with immuno suppressive treatment of aplastic anemia in a nontransplant setting, T hus, when presenting options for treatment of aplastic anemia, lymphop roliferative disorders should be included as a rare complication of im munosuppressive therapy. (C) 1996 Wiley-Liss, Inc.