THYMOMA-ASSOCIATED PANCYTOPENIA - EFFECTIVENESS OF CYCLOSPORINE-A

Aplastic anemia is a rare complication of thymoma and is properly docu mented in only few cases. Here, we report the case of a previously hea lthy, 65-year-old patient who was found simultaneously to have a spind le-cell thymoma and severe hypoplastic anemia with a mild infiltration of the bone marrow by CD4+ and CD8+ T lymphocytes, CD16+ natural kill er cells, and a decrease in blood CD4/CD8 ratio. Cultures of marrow er ythroid progenitors demonstrated serum inhibitor. While steroids, cycl ophosphamide and antilymphocyte globulin failed to improve hematopoies is, cyclosporine A (Cy-A) led to a partial, stable remission that was sustained for 4 years. Since Cy-A has been associated with good respon ses in three cases of thymoma-associated red cell aplasia, we recommen d its use in cases of thymoma-associated cytopenias refractory to ster oids and cyclophosphamide.