Effective treatment of aplastic anemia secondary to chemoradiotherapy using cyclosporine A

Aplastic anemia(AA)is a bone marrow failure syndrome that can be classified as either congenital or acquired AA.Most cases of acquired AA are idiopathic,in which the abnormal immune system attacks bone marrow hematopoietic stem cells and their microenvironment.[1]Some AA is secondary to radiotherapy and/or chemotherapy.However,most of the cytopenia can recover within 1 to 2 months after stopping the chemoradiotherapy,because bone marrow suppression therapies are devised to be reversible.Even though,some patients fail to recover from the hematopoiesis after more than 3 therapy-free months.These patients,who were diagnosed as AA after careful workup,were unable to continue with their planned chemoradiotherapy,and sometimes suffered from or died of infections or bleeding caused by severe cytopenia,or relapse from the primary tumors.The extensive use of bone marrow suppression therapy in patients with malignant tumors has been associated with an increase in therapy-related AA.Unfortunately,there are currently no guidelines or consensus on the management of these patients.In this study,we explored the efficacy and safety of cyclosporine A(CsA)in these patients.