Ticlopidine-induced aplastic anemia: Development of chromosomal abnormalities and response to immunosuppressive therapy

Severe aplastic anemia is a well-recognized complication of ticlopidine the rapy that carries a high mortality. Therapy with colony-stimulating factors or corticosteroids has been largely ineffective in this disorder. We repor t a case of ticlopidine-induced aplastic anemia that was successfully treat ed with cyclosporine and high-dose dexamethasone. The patient rapidly respo nded to immunosuppressive therapy and had a normal hemogram after cessation of immunosuppression, On long-term follow-up, the patient developed a prog ressive macrocytic anemia. Repeat bone marrow evaluation demonstrated myelo dysplasia with erythroid hypoplasia. An associated chromosomal abnormality consisting of a t(3;16) (q21; p13.3) translocation was detected. This is th e first report of a chromosomal abnormality associated with ticlopidine ind uced marrow aplastic anemia. Am. J. Hematol. 63:141-144, 2000. (C) 2000 Wil ey-Liss, Inc.