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Morphological characteristics of lymphocytes and the response to cyclosporine treatment have revealed some unique patients with pure red cell aplasia. Lymphocytes from these patients consisted mainly of non-granulated lymphocytes. All of the patients were successfully managed by cyclosporine monotherapy irrespective of prior treatment. A reduction in lymphocyte mass was not a prerequisite for the remission of pure red cell aplasia, and responses occurred within 1 month from the start of therapy. Clonal T-cell proliferation was detected in four patients, which raised the possibility of idiopathic pure red cell aplasia being associated with a clonal proliferation of T cells. An examination of the lymphocytes in patients with pure red cell aplasia could potentially be used to plan better therapeutic modalities and assess prognosis.
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