Letter to the Editor

Rituximab is Effective in the Treatment of Refractory Immune Thrombocytopenic Purpura Associated with Chronic Lymphocytic Leukemia

Authors: Thein H. Oo, MD

Abstract

Two percent of chronic lymphocytic leukemia (CLL) patients present with immune thrombocytopenic purpura (ITP). Corticosteroids, immune globulins (IVIG) and splenectomy remain the mainstay of treatment for ITP. Rituximab is a monoclonal antibody against CD20 antigen expressed on B-lymphocytes. Because of its B-cell depleting capability, it has been employed in the treatment of autoimmune diseases. Many case reports and series have reported its efficacy in the treatment of refractory ITP.1 However, its efficacy in CLL-associated ITP is not well known. Here, a patient with refractory CLL-associated ITP, successfully treated with rituximab, is described.

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References

1.Kazkaz H, Isenberg D. Anti B cell therapy (rituximab) in the treatment of autoimmune diseases. Curr Opin Pharmacol 2004;4:398–402.
 
2.Zaja F, Vianelli N, Sperotto A, et al. Anti-CD20 therapy for chronic lymphocytic leukemia-associated autoimmune diseases. Leukemia & Lymphoma 2003;44:1951–1955.
 
3.Hegde UP, Wilson WH, White T, et al. Rituximab treatment of refractory fludarabine-associated immune thrombocytopenia in chronic lymphocytic leukemia. Blood 2002;100:2260–2262.
 
4.Jacoub J, Mchlayeh W, Tabbara I, et al. The use of anti-CD20 chimeric monoclonal antibody, rituximab, in adult patients with treatment refractory immune thrombo-cytopenia. [Abstract #3050] Blood2004;104:74b.
 
5.Cabrera JR, Penalver FJ, Milan I, et al. Mabthera (Rituximab) in the treatment of 92 patients with refractory immune thrombocytopenic purpura. [Abstract #2074] Blood 2004;104:571a.