Treatment for 6 cases of refractory autoimmune cytopenias by sirolimus and literature review

Abstract

Objective \nTo discuss the efficacy of sirolimus in the treatment of refractory autoimmune cytopenias. \n \n \nMethods \nClinical data of 6 patients with refractory autoimmune cytopenias admitted to the First Affiliated Hospital of Zhengzhou University from October 2017 to October 2018 were retrospectively analyzed. The 6 patients included 4 males and 2 females, with a median age of 38 (23- 55) years old, disease duration of 4 months to 9 years. Three cases of the 6 patients had immune-related pancytopenia, 2 cases had Evans syndrome, and 1 case had immune thrombocytopenia. Six patients were treated by conventional treatment, but did not get good results, so that they were given sirolimus 0.2 to 1.0 mg/d orally; of them, 5 patients were treated with glucocorticoid or cyclosporine, and the dosages of hormones and cyclosporine were reduced after the blood loss increased. And the efficacy was analyzed. \n \n \nResults \nAmong the 6 patients with refractory autoimmune cytopenias, 3 cases achieved complete remission, 2 cases had partial remission, and 1 case had ineffective result after oral treatment with sirolimus. \n \n \nConclusions \nSirolimus is effective and safe in the treatment of refractory autoimmune cytopenias, but its effect needs to be clinically validated by multi-center and large sample research. The treatment method has broad prospects for treatment of blood diseases. \n \n \nKey words: \nAutoimmune cytopenias;\xa0Sirolimus;\xa0Azole antifungal agents