Chronic Lymphocytic Leukemia-associated Immune Thrombocytopenia Successfully Treated with Rituximab: A Case Report
Abstract
Chronic lymphocytic leukemia (CLL) may become complicated with otoimmune diseases during it's clinical course. Immune thrombocyto-penia (IT) has a 2% prevelance in the clinical course of CLL. Also IT indicates a poor prognosis. There are no standard terapies for CLL-associated IT so far. A 48-year-old male patient was diagnosed with stage I CLL at Uludag University Faculty of Medicine Hematology Department. Initial thrombocyte count during diagnosis was 4.810/mm³. He was started a 1 mg/kg/d dose of steroids regimen as a first-line therapy to which the patient did not respond. Later, for a time period of two days he was given high dose (1 g/kg/d) IVIG but again there was no response to the treatment. One course of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone) chemotherapy was applied as cytotoxic treatment. Thrombocyte counts of the patient were below 25.000/mm³ after the third week of treatment. We consid-ered this as limited-response and started the patient on 375 mg/m²/d dose of rituximab therapy per week for a total of four weeks. Thrombo-cyte count was up to 95.000/mm³ after treatment and it was 52.900/mm³ at the end of the fourth dose of rituximab which we considered as partial-response. Therefore we believe the rituximab therapy to be efficient and well-tolerated alternative in this case.
Rituksimab ile Başarılı Şekilde Tedavi Edilen İmmun Trombositopenili Kronik Lenfositik Lösemi: Olgu Sunumu
Abstract
Kronik lenfositik lösemi (KLL) klinik seyri sırasında otoimmun hastalıklarla komplike olabilmektedir. İmmun trombositopeni (İT) KLL seyrinde %2 oranında görülür. Bununla birlikte varlığı kötü prognoz ile ilişkilidir. İT ile birlikte olan KLL'nin standart bir tedavisi yoktur. Kırksekiz yaşında erkek olguya Uludağ Üniversitesi Tıp Fakültesi Hematoloji B.D.'da evre I KLL tanısı konuldu. İlk tanıda trombosit 4.810/mmᵌ idi. Birinci basamak tedavi olarak 1 mg/kg/gün dozunda steroid verildi. Yanıt alınamadı. İki gün yüksek doz İVİG (1 g/kg/gün) tedavisi uygulandı. Yine yanıt alınamadı. Sitotoksik tedavi olarak 1 kür R-CHOP kemoterapisi uygulandı. Tedavinin 3. haftasından sonra trombositler 25.000/mm³'nin altında seyretti. Bir miktar yanıtlı gördüğümüz hastamıza 1 hafta ara ile 375 mg/m²/gün dozunda toplam 4 hafta rituksimab tedavisi uygulandı. Tedavi sonunda trombosit sayısı maksimum 95.000/mmᵌ'e ulaşırken 4. doz sonrası trombosit değeri 52.900/mm³ idi. Kısmi yanıtlı kabul edildi. Biz olgumuzda rituksimab tedavisinin etkili ve iyi tolere edilen bir alternatif olduğunu düşünmekteyiz.
Details
| Other ID | JA87SY76PY |
|---|---|
| Authors | |
| Publication Date | September 1, 2013 |
| Published in Issue | Year 2013 Volume: 39 Issue: 3 |
ISSN: 1300-414X, e-ISSN: 2645-9027
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Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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