[Use of cyclosporin A in hematology]

We present an overview of clinical conditions where cyclosporin A (CyA) could be used in the treatment of hematological diseases. CyA is an effective immunosuppressive agent. It has long been successfully used in organ transplants and bone marrow transplants. The strong immunosuppressive effect of CyA makes this agent useful in various autoimmune diseases. The indication of CyA in certain hematological diseases has recently been steadily expanding. Based on the influence of CyA on cell immunity, the creation of cytokines and subsequently on humoral immunity we try to elucidate or justify its use in specific hematological diseases with regards to their pathophysiology. The common denominator to the diseases discussed below is a certain form of autoaggression. We include for example idiopathic autoimmune hemolytic anemia (AIHA) idiopathic thrombocytopenic (ITP), Evans syndrome, pure red cell aplasia. In certain sense we can include here even aplastic anemia (AA) and myelodysplastic syndrome (MDS). Furthermore, it is possible to use CyA for its ingerence to the proliferation and activation of T-cells in some T-lymphoproliferations and in histiocytoses. In B-lymphoproliferation the use of CyA will probably require further studies. We briefly note the possibility of influencing multiple drug resistance (MDR) with CyA.