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.
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