Successful treatment of refractory pure red cell aplasia by buserelin acetate

A 39-year-old female with autoimmune hemolytic anemia suffered from pure red cell aplasia. She received immunosuppressive agents including prednisolone, azathioprine, cyclophosphamide and methotrexate, resulting in a little improvement of the anemia for only short term. Consequently, she required multiple red cell transfusions for 3 years. She received buserelin acetate, a gonadotropin-releasing hormone analogue. Thereafter, the anemia dramatically improved. The direct effect of buserelin on hemopoietic progenitors was not detected in the in vitro culture study. It is most likely that buserelin enhanced erythropoiesis through the alteration of hormonal milieu. The usefulness of buserelin in the treatment of refractory pure red cell aplasia is discussed.