Cyclosporine treatment for patients with CRF who developed pure red blood cell aplasia following EPO therapy

Anti-Erythropoietin Antibodies and Pure Red Cell Aplasia

“…Analysis of the 36 aforementioned cases shows that recovery was observed in 11 of 19 cases treated with corticosteroids (58%), in six of eight cases who received corticosteroids plus cyclophosphamide (75%), in 4 of 6 cases treated with cyclosporine (67%), and in all six patients who had a kidney transplant. Three additional patients have been reported who rapidly recovered from epoetin-induced PRCA after receiving a kidney transplant (35). In contrast, treatment with high doses of immunoglobulins was successful in only one case of nine.…”

Recovery from Pure Red Cell Aplasia Caused by Anti Erythropoietin Antibodies After Kidney Transplantation

“…Similar results on humoral response have also been found for many other endogenous or exogenous antigens. However, we cannot rule out the possibility that the calcineurin inhibitor tacrolimus is involved, as Chng and coworkers have reported three cases in which PRCA owing to anti-EPO was resolved by cyclosporine therapy (11). However, in the case reported by Chng et al the trough levels were higher than those targeted for our patient when he developed anti-EPO antibodies.…”

“…Our patient developed anti-EPO antibodies despite triple immunosuppressive therapy including cyclosporine, which has recently been shown to treat acquired PRCA owing to anti-EPO alone (11). We hypothesize that a strong and global increase in immunosuppression could control or block the production of antierythropoietin antibodies.…”

Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica

“…12,1 -Volumen corpuscular medio (u3) 94 -Concentración de hemoglobina corpuscular media (%) 35 -Leucocitos (mm3) 10.800 -Plaquetas (mm3)…”

“…En los últimos años se ha descrito aplasia pura de células rojas en pacientes en hemodiálisis crónica que utilizan eritropoyetina recombinante humana [8][9][10] . Se produciría la formación de anticuerpos neutralizantes anti-eritropoyetina capaces de inhibir en cultivos in vitro la formación de colonias eritroides de células medulares de sujetos normales.…”