Introduction:  There are no standard therapies for chronic lymphocytic leukemia (CLL)-associated immune thrombocytopenia (IT) so far. Patients and methods:  We report the results of therapy with single agent rituximab in 21 patients with CLL-associated IT. The mean age at CLL and IT diagnosis was 64 and 68 years, respectively. IT developed at a mean time of 44 months from the diagnosis of CLL. In 4 cases IT was diagnosed at the same time as CLL. For 3 patients IT was considered fludarabine-related and 2 patients showed autoimmune hemolysis also. All patients but one, received steroids as first-line treatment for IT. Some patients received intravenous high-dose Ig, vincristine and cytoxan also, without beneficial effect. After a mean time of 43 days from the diagnosis of IT all patients were scheduled to receive rituximab at a dosage of 375 mg/mq/weekly. Results:  Eighteen (86%) patients completed the scheduled 4 cycles of rituximab. Irrelevant first infusion side effects were seen only in 1 patient. Twelve (57%) patients showed a complete response (CR), 6 (29%) patients a partial response (PR) and 3 (14%) patients did not respond. In responding patients, the mean duration of response was 21 months (4 - 49 months). At a mean follow-up of 28 months, 14 (66%) patients were still alive, 10 (48%) of them in CR and 3 (14%) in PR. Conclusions:  This retrospective analysis prove that rituximab is an effective and well-tolerated alternative treatment for CLL-associated IT.

CHRONIC LYMPHOCYTIC LEUKEMIA-ASSOCIATED IMMUNE THROMBOCYTOPENIA TREATED WITH RITUXIMAB: ARETROSPECTIVE STUDY OF 21 PATIENTS

DEAGLIO, Silvia;
2010-01-01

Abstract

Introduction:  There are no standard therapies for chronic lymphocytic leukemia (CLL)-associated immune thrombocytopenia (IT) so far. Patients and methods:  We report the results of therapy with single agent rituximab in 21 patients with CLL-associated IT. The mean age at CLL and IT diagnosis was 64 and 68 years, respectively. IT developed at a mean time of 44 months from the diagnosis of CLL. In 4 cases IT was diagnosed at the same time as CLL. For 3 patients IT was considered fludarabine-related and 2 patients showed autoimmune hemolysis also. All patients but one, received steroids as first-line treatment for IT. Some patients received intravenous high-dose Ig, vincristine and cytoxan also, without beneficial effect. After a mean time of 43 days from the diagnosis of IT all patients were scheduled to receive rituximab at a dosage of 375 mg/mq/weekly. Results:  Eighteen (86%) patients completed the scheduled 4 cycles of rituximab. Irrelevant first infusion side effects were seen only in 1 patient. Twelve (57%) patients showed a complete response (CR), 6 (29%) patients a partial response (PR) and 3 (14%) patients did not respond. In responding patients, the mean duration of response was 21 months (4 - 49 months). At a mean follow-up of 28 months, 14 (66%) patients were still alive, 10 (48%) of them in CR and 3 (14%) in PR. Conclusions:  This retrospective analysis prove that rituximab is an effective and well-tolerated alternative treatment for CLL-associated IT.
2010
85(6)
502
507
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0609.2010.01527.x/pdf
immune thrombocytopenia; chronic lymphocytic leukemia; rituximab
D'Arena G; Capalbo S; Laurenti L; Del Poeta G; Nunziata G; Deaglio S; Spinosa G; Tarnani M; Di Padua L; Califano C; Ferrara F; Cascavilla N
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/74998
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