Complete remission of refractory anemia following a single high dose of cyclophosphamide

We describe a case of stable complete remission in a patient with refractor y anemia complicated by severe autoimmune hemolytic anemia, achieved with a single high dose (4 g/m(2)) of cyclophosphamide (cyclo). Concomitantly, an effective mobilization of CD34-positive cells was induced. Other immunosup pressive approaches including high-dose methylprednisolone, high-dose immun oglobulin, and cyclosporine had been ineffective. This finding suggests tha t, in selected cases, an immunologic mechanism may mediate cytopenia in mye lodysplastic syndromes (MDS), In addition, it demonstrates that successful mobilization of peripheral blood stem cells can be induced with high-dose c ycle in MDS.