Journal
PEDIATRIC BLOOD & CANCER
Volume 61, Issue 11, Pages 2112-2114Publisher
WILEY-BLACKWELL
DOI: 10.1002/pbc.25122
Keywords
bortezomib; cord blood; Evans syndrome; pediatric hematology; oncology; stem cell transplantation; vincristine
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Autoimmune cytopenias (AC) after allogeneic hematopoietic stem cell transplantation (HSCT) are associated with a dismal prognosis. We describe a 1-year-old female with multi-lineage AC occurring on day +43 after HSCT. Multi-agent treatment with high-dose prednisolone, intravenous immunoglobulins, cyclosporine A, mycophenolate mofetil, sirolimus, and rituximab was unsuccessful. Combined treatment with bortezomib and vincristine in addition to ongoing immunosuppressive therapy was started on day +414 with transfusion-independence after day +444. Immunosuppressants were tapered until day +638. On day +1,121 the patient remained in remission. Bortezomib with vincristine may be a promising treatment modality for refractory AC after HSCT that requires further study. Pediatr Blood Cancer 2014;61:2112-2114. (c) 2014 Wiley Periodicals, Inc.
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