SUCCESSFUL TREATMENT OF VIRUS-ASSOCIATED HEMOPHAGOCYTIC SYNDROME IN ADULTS BY CYCLOSPORINE-A SUPPORTED BY GRANULOCYTE-COLONY-STIMULATING FACTOR

Two young adult patients with typical virus-associated haemophagocytic syndrome (VAHS) were treated with cyclosporin A and granulocyte colon y-stimulating factor (G-CSF). Clinical symptoms such as high fever and malaise disappeared rapidly with concurrent haematological improvemen t in both patients. The serum levels of interleukin-6 (IL-6), soluble IL-2 receptor, tumour necrosis factor and macrophage-CSF were all elev ated before treatment but that of G-CSF was not. The dramatic effect o f cyclosporin A observed implies that it efficiently and rapidly suppr esses the cytokine storm caused by dysregulated T cells in VAHS. In ad dition, G-CSF may promote haematological recovery without syndrome reg ression. We believe that the combination of cyclosporin A and G-CSF ma y be effective, at least in selected patients with VAHS. Further studi es are required to confirm its role as first-line therapy for adult pa tients with VAHS.