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Acquired amegakaryocytic thrombocytopenia and red cell aplasia in a patient with thymoma progressing to aplastic anemia successfully treated with allogenic stem cell transplantation.

Treatment Used: Allogenic Stem Cell Transplantation (allo-SCT)
Number of Patients: 1
MediFind Summary

Overview: This case report discusses a patient with thymoma complicated by pure red cell aplasia (PRCA) and acquired amegakaryocytic thrombocytopenia (AAMT) who progressed to develop aplastic anemia (AA) treated with allogeneic stem cell transplantation (allo-SCT).

Conclusion: On Day +323 the patient continues to be transfusion-independent. This case illustrates how in patients with thymoma and acquired amegakaryocytic thrombocytopenia may herald development of  aplastic anemia. This is also the first report of a patient with acquired amegakaryocytic thrombocytopenia progressing to thymoma-associated aplastic anemia being successfully treated with allogeneic stem cell transplantation. The successful outcome suggests allogeneic stem cell transplantation as a feasible option similar to other patients with aplastic anemia.

Abstract

Association of pure red-cell aplasia with thymoma is well documented. However, acquired amegakaryocytic thrombocytopenia (AAMT) has been rarely associated with thymoma with only five reported cases in literature. We report a patient with thymoma complicated by pure red cell aplasia (PRCA) and AAMT who progressed to develop aplastic anemia (AA). The patient was refractory to 10-months of immunosuppressive therapy with cyclosporine, prednisone, and antithymocyte globulin. She was eventually treated with allogeneic stem cell transplantation (allo-SCT). On Day +323 the patient continues to be transfusion-independent. This case illustrates how in patients with thymoma and AAMT may herald development of AA. This is also the first report of a patient with AAMT progressing to thymoma-associated AA being successfully treated with allo-SCT. The successful outcome suggests allo-SCT as a feasible option similar to other AA patients.

Authors
Aron Simkins, Abhishek Maiti, Nicholas Short, Nitin Jain, Uday Popat, Keyur Patel, Thein Oo

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