The efficacy of alemtuzumab for pure red cell aplasia associated with autoimmune polyendocrine syndrome type 1.

Journal: [Rinsho Ketsueki] The Japanese Journal Of Clinical Hematology
Treatment Used: Alemtuzumab
Number of Patients: 1
MediFind Summary

Overview: This article reviewed the case of a patient with pure red cell aplasia (severe failure of production of red blood cells by the bone marrow with normal production of other blood cells) associated with autoimmune polyendocrine syndrome type 1 (inherited autoimmune condition that affects many of the body's organs; APS-1) treated with alemtuzumab.

Conclusion: Alemtuzumab treatment resulted in the disappearance of large granular lymphocytes (rare cancer of a type of white blood cells called lymphocytes) and improvement of anemia (not enough healthy red blood cells to carry adequate oxygen to the body's tissues).

Abstract

We present a case of a 41-year-old woman who was diagnosed with autoimmune polyendocrine syndrome type 1 (APS-1) at the age of 2. She developed severe anemia and was diagnosed with pure red cell aplasia (PRCA) and T-cell large granular lymphocyte leukemia at the age of 34. The pathogenesis of APS-1 is based on the presence of an inactive mutation in the autoimmune regulator gene on thymic medullary epithelial cells. It is thought that the autoimmune T cells generated by impaired negative selection in the thymus induce PRCA. The patient was treated with immunosuppressive therapy (ciclosporin, antithymocyte globulin, prednisolone, and cyclophosphamide) for a long time by her previous doctor. After a long period of remission and exacerbation, she became dependent on blood transfusion approximately at the age of 40 and was transferred to our hospital. At our hospital, alemtuzumab treatment resulted in the disappearance of large granular lymphocytes and improvement of anemia. We report this case as a valuable demonstration of the efficacy of alemtuzumab for treating PRCA associated with APS-1.

Authors
Michiaki Sato, Masahiro Shino, Kazuaki Yokoyama, Taiki Ishida, Masako Hirao, Yoshimasa Kamoda, Hiromitsu Iizuka, Michiko Kida, Seiya Imoto, Arinobu Tojo, Kensuke Usuki

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