Successful Treatment of Refractory TAFRO Syndrome with Cyclophosphamide: A Report of Two Cases

Abstract

TAFRO syndrome is a rare, severe, and sometimes refractory condition characterized by thrombocytopenia, anasarca, a fever, reticulin myelofibrosis, and organomegaly. Although several treatment options have been proposed for this condition, there are few reported cases in the literature on successful treatment using cyclophosphamide in patients with TAFRO syndrome. We herein report two cases of refractory TAFRO syndrome successfully treated with intravenous cyclophosphamide. In both cases, after the initial treatment with high-dose glucocorticoids and tocilizumab failed, the administration of intravenous cyclophosphamide led to significant improvement. These cases suggest that intravenous cyclophosphamide may be a viable therapeutic option for refractory TAFRO syndromes.