PMC7372523_01
Bone marrow smear showing decreased erythropoiesis (a) and the
precursors of other lineages showing no other abnormalities (b)
in July 2015.
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The results of bone marrow morphology showed decreased erythropoiesis with a myeloid/erythroid ratio of 25:1, whereas precursors of other lineages were well detected without abnormalities (Figure 1).
Change of Hgb level from when immunosuppression therapy with CsA
and GS was started in July 2015.. BRT, bortezomib; CsA, cyclosporin A; CTX, cyclophosphamide; GS,
glucocorticoids; Hgb, hemoglobin; rhE, recombinant human
erythropoietin; RTX, rituximab.
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February 2017, at which point CsA was administered at 200 mg/day. From February 2017 to December 2018, recurrence occurred four times after drug tapering and the patient recovered each time when the dose was increased (Figure 2). The Hgb level was maintained within 50-60 g/L during this period (Figure 2). During follow up, the patient came back to our clinic in March 2020 with an Hgb level of 140 g/L, a normal platelet level, and without any overt symptoms (Figure 2).