Red Cell Aplasia in Children on Tacrolimus After Liver Transplantation

Misra, Sudipta; Moore, Theodore B.; Ament, Marvin E.; Busuttil, Ronald W.; McDiarmid, Sue V.

doi:10.1097/00007890-199802270-00021

Cited by 44 publications

(27 citation statements)

References 4 publications

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“…Although a few cases of tacrolimus‐associated PRCA due to drug toxicity have been documented (Suzuki et al. , 1996; Misra et al. , 1998), this is, to our knowledge, the first case reported in which tacrolimus is effective when used in combination with corticosteroids in CyA‐resistant PRCA.…”

Section: Discussionmentioning

confidence: 77%

Effect of tacrolimus in a patient with pure red-cell aplasia

et al. 2005

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A 78-year-old woman has suffered from pure red-cell aplasia (PRCA) associated with generalized myasthenia gravis and thymoma. Cyclosporin A (CyA) with corticosteroid increased numbers of erythroid cells in her bone marrow cells but she required monthly blood transfusions. Administration of tacrolimus as a substitution for CyA inhibited progression of anemia without the need for further blood transfusion. No serious side effects were observed. This case demonstrates that tacrolimus is another option of treatment for PRCA in patients who fail to respond to CyA.

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Section: Discussionmentioning

confidence: 77%

Effect of tacrolimus in a patient with pure red-cell aplasia

et al. 2005

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“…Tacrolimus can bind to FKBP in T lymphocytes and the final outcome is inhibition of the gene transcription for IL-2 and other transcription factors essential to early T cell activation [4]. Hematopoietic abnormalities associated with tacrolimus are rare with reversible pure red cell aplasia the most common [5][6][7][8]. The mechanism by which tacrolimus causes bone marrow hypoplasia is unclear.…”

Section: Discussionmentioning

confidence: 99%

Association of Long-Term Tacrolimus (FK506) Therapy with Abnormal Megakaryocytosis, Bone Marrow Fibrosis, and Dyserythropoiesis

Yang

Loew

Hammer

2014

American Journal of Clinical Pathology

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“…82,83 In addition, tacrolimus can cause red cell aplasia in children. 84 Patients maintained on mycophenolate mofetil or azathioprine in combination with cyclosporine and corticosteroids develop anemia in 43% and 53%, respectively. Other drugs commonly used post-OLT also contribute to anemia, such as dapsone, trimethoprim-sulfamethoxazole, ganciclovir, and other antimicrobials.…”

Section: Anemia and Neutropenia Post-liver Transplantationmentioning

confidence: 99%

Role of Growth Factors in the Treatment of Patients With HIV/HCV Coinfection and Patients With Recurrent Hepatitis C Following Liver Transplantation

Fredrick

Hassanein

2005

Journal of Clinical Gastroenterology

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Hepatitis C (HCV) contributes significantly to the morbidity and mortality of patients coinfected with human immunodeficiency virus (HIV) and those with recurrent hepatitis C after successful liver transplantation. Treatment of hepatitis C in these patient populations, while crucial, can be quite challenging. Baseline cytopenias, in particular, may limit dosing of interferon and/or ribavirin or preclude therapy entirely when standard guidelines are followed. Concomitant medications, opportunistic infections, and other bone marrow insults account for the anemia, neutropenia, and thrombocytopenia frequently encountered in these patients. Sustained virologic response rates in published series for HIV/HCV and post-transplantation HCV have not reached those seen in treatment of HCV alone, despite the highly selected patient populations chosen for these studies. Hematopoietic growth factors such as erythropoietin and granulocyte-colony stimulating factors may be used to improve the anemia and neutropenia seen during treatment of HCV. Reported experience with these growth factors is limited in HIV/HCV coinfected patients, but studies are underway to determine if growth factors improve adherence to therapy and perhaps virologic response rates. Post-transplantation studies of HCV therapy have reported more liberal use of growth factors; however, discontinuation rates have been high and virologic response rates have been disappointing. Further study of growth factors as a means to increase sustained virologic response rates and maintain adequate dosing and duration of interferon and ribavirin therapy in these patient populations is needed.

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Red Cell Aplasia in Children on Tacrolimus After Liver Transplantation

Cited by 44 publications

References 4 publications

Effect of tacrolimus in a patient with pure red-cell aplasia

Effect of tacrolimus in a patient with pure red-cell aplasia

Association of Long-Term Tacrolimus (FK506) Therapy with Abnormal Megakaryocytosis, Bone Marrow Fibrosis, and Dyserythropoiesis

Role of Growth Factors in the Treatment of Patients With HIV/HCV Coinfection and Patients With Recurrent Hepatitis C Following Liver Transplantation

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