Thymoma-associated pancytopenia: immunosuppressive therapy is the cornerstone for durable hematological remission

Pancytopenia is a very rare complication of thymoma and has been sporadically reported in only a few cases. We report a case of a 68-year-old woman who presented with pancytopenia associated with thymoma. After failing high-dose corticosteroids, she responded to cyclosporine treatment and underwent successful thymectomy. We also reviewed all other similar cases published in the English language literature. Surgical resection by itself was generally ineffective for treatment of pancytopenia, and immunosuppressive therapy was required for bone marrow recovery. Resolution of pancytopenia was most frequently associated with cyclosporine-based therapy with a response rate (RR) of 66.6 %. In conclusion, pancytopenia associated with thymoma requires medical treatment, and the evidence presented here suggests that a cyclosporine-based regimen should be considered for initial therapy.