Transient response of pure red cell aplasia to anti-thymocyte globulin in a patient with T-cell chronic lymphocytic...

Pure red cell aplasia (PRCA) is an unusual complication of chronic lymphoproliferative disorders. A patient with T-cell chronic lymphocytic leukemia (T-CLL) had severe anemia and neutropenia. Initial in vitro studies demonstrated no evidence of T-cell suppression of erythropoiesis. Sequential bone marrow examinations demonstrated progressive red cell aplasia. In vitro studies showed that the T-cells from the patient suppressed allogeneic but not autologous BFU-E. Treatment with antithymocyte globulin (ATG) reduced circulating leukemic cells and produced a definite but transient improvement in erythropoiesis.