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Suggest alternative medication for Cyclosporine taken for pure red cell aplasia

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Posted on Mon, 9 May 2016
Question: My mom have pure red blood cell aplasia for over 10 years and took cyclesporine for over 10 years to control.
However recently the medicine seems not functioning anymore, so she took blood transfusion every month to maintain the red blood cell. I am wondering if there is any alternative drug that may be useful.
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Answered by Dr. Hardik Sanghvi (1 hour later)
Brief Answer:
Other immunosupressive agents or newer drugs can be used.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
She has pure red cell aplasia and she is taking treatment for more then 10 years so I assume that there is no underlying cause or the underlying cause is treated.

I have seen few cases in which pure red cell aplasia is treated with cyclosporine and over the period of time relapse of anemia occur. Cyclosporine may not be able to control the disease and patient become transfusion dependent.

In many cases re-induction therapy of cyclosporine is helpful.
If it is not helpful then cyclosporine and cyclophosphamide combination is useful.
Danazol or newer drugs like rituximab can be tried in different combinations.

Allogenic peripheral stem cell transplantation is the other option in refractory anemia which is not responding to drug.

So you should discuss this options with your hematologist and best possible options according to patient condition is used.

Blood transfusion is necessary till other drugs come in to action.

Control of infection by immunoglobulin is also useful in immunosupression.

Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for usign health care magic. Wish you a very good health.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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Suggest alternative medication for Cyclosporine taken for pure red cell aplasia

Brief Answer: Other immunosupressive agents or newer drugs can be used. Detailed Answer: Hi, dear I have gone through your question. I can understand your concern. She has pure red cell aplasia and she is taking treatment for more then 10 years so I assume that there is no underlying cause or the underlying cause is treated. I have seen few cases in which pure red cell aplasia is treated with cyclosporine and over the period of time relapse of anemia occur. Cyclosporine may not be able to control the disease and patient become transfusion dependent. In many cases re-induction therapy of cyclosporine is helpful. If it is not helpful then cyclosporine and cyclophosphamide combination is useful. Danazol or newer drugs like rituximab can be tried in different combinations. Allogenic peripheral stem cell transplantation is the other option in refractory anemia which is not responding to drug. So you should discuss this options with your hematologist and best possible options according to patient condition is used. Blood transfusion is necessary till other drugs come in to action. Control of infection by immunoglobulin is also useful in immunosupression. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for usign health care magic. Wish you a very good health.