Acquired Amegakaryocytic Thrombocytopenia and Red Cell Aplasia in a Patient with Thymoma Progressing to Aplastic Anemia Successfully Treated with Allogenic Stem Cell Transplantation

Publication date: Available online 31 January 2018
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Aron Simkins, Abhishek Maiti, Nicholas J. Short, Nitin Jain, Uday Popat, Keyur P. Patel, Thein H. Oo
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.



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