Supplementary Material for: Cyclosporine A combined with Rituximab successfully treated erythropoietin-induced pure red blood cell aplastic anemia

Erythropoietin-induced pure red blood cell aplastic anemia (EPO-PRCA) is a rare anemia，which presents a significant treatment challenge, often necessitating the cessation of erythropoiesis-stimulating agents (ESAs) and the adoption of immunosuppressive therapies or renal transplantation. In the present case, the patient developed severe anemia after 2-year EPO treatment and was diagnosed with EPO-PRCA. The treatment with the full dose of corticosteroids and testosterone for one month failed to increase his hemoglobin (Hb) level significantly. Therefore, the patient received the combination therapy of cyclosporine A (CsA) with rituximab, which effectively cleared the anti-EPO antibody. Then Roxadustat was given to improve renal anemia. As Hb level increased gradually, the patient was recovered from EPO-PRCA. This case reported an EPO-PRCA patient was successfully cured by the combination of CsA with rituximab and provided another choice for the treatment of EPO-PRCA in the future.

促红细胞生成素诱导的纯红细胞再生障碍性贫血（EPO-PRCA）是一种罕见的贫血类型，临床治疗难度极大，通常需要停用红细胞生成刺激剂（ESAs），并采用免疫抑制疗法或肾移植方案。本病例中，患者接受2年促红细胞生成素治疗后出现重度贫血，确诊为EPO-PRCA。予以足量糖皮质激素与睾酮治疗1个月后，其血红蛋白（Hb）水平未能得到显著提升。遂给予环孢素A（CsA）联合利妥昔单抗的联合治疗方案，有效清除了抗促红细胞生成素抗体；随后予罗沙司他以改善肾性贫血。随着血红蛋白水平逐步升高，患者的EPO-PRCA得以康复。本病例报告了1例经CsA联合利妥昔单抗治疗成功治愈的EPO-PRCA患者，为未来EPO-PRCA的临床治疗提供了新的选择。