Treatment of refractory Evans syndrome with alternate-day cyclosporine and prednisone

Am J Pediatr Hematol Oncol. 1994 May;16(2):156-9.


Purpose: We report that the use of alternate-day cyclosporine and prednisone improved the clinical course of a 6-year-old child with severe Evans syndrome. Before the use of cyclosporine the child had experienced life-threatening episodes of hemolytic anemia despite the use of multiple therapeutic modalities.

Methods: Cyclosporine was given at a dose of 10 mg/kg/day divided into two doses on alternate days.

Results: The use of cyclosporine resulted in increased hemoglobin levels, increased platelet counts, and the reduction of the patient's prednisone dose from 2 mg/kg/day to as low as 1 mg/kg every other day. With this regimen, the patient had less severe hemolytic anemia, was less thrombocytopenic, and had fewer hospitalizations. No major toxic effects were associated with cyclosporine therapy.

Conclusion: The regimen of alternate-day cyclosporine and prednisone may prove to be useful in the treatment of other patients with refractory Evans syndrome.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Hemolytic, Autoimmune / drug therapy*
  • Child
  • Cyclosporine / administration & dosage*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Humans
  • Prednisone / administration & dosage*
  • Syndrome
  • Thrombocytopenia / drug therapy*


  • Cyclosporine
  • Prednisone