Chronic lymphocytic leukemia-associated refractory immune thrombocytopenia successfully treated with eltrombopag

Agnaldo Lopes da Silva Filho, Agnaldo Lopes da Silva-Filho, Hung Chang, Lee-Yung Shih, Márcia Cristina França Ferreira, Rívia Mara Lamaita, Ana Luiza Lunardi Rocha, Eduardo Batista Cândido, Márcia Mendonça Carneiro
Journal of Endometriosis and Pelvic Pain Disorders · 2015 · vol. 8(3) , pp. 81–86 · doi:10.5301/je.5000248 · PMID:25702666 · W2523180857
Case report OA: closed CC0 ⤵ 1 in-corpus citation
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This case report describes a patient with CLL and refractory ITP experiencing major bleeding, who achieved normal platelet counts and stopped bleeding after treatment with eltrombopag.

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Abstract

Chronic lymphocytic leukemia (CLL) may be associated with immune thrombocytopenia (ITP). The standard treatment for CLL-associated ITP is steroids. For refractory cases, various treatment strategies such as rituximab, splenectomy, and thrombopoietic mimetics are available. We report a patient with CLL who developed recurrent ITP and life-threatening pulmonary hemorrhage. Platelet counts remained extremely low despite massive platelet transfusion and treatment including steroids, immunoglobulin, and single-dose rituximab infusion. The bleeding stopped and platelet counts were increased to normal range 13 days after treatment with eltrombopag 25 mg per day. Our experience suggests that eltrombopag is an effective treatment option in CLL-associated, refractory ITP, especially during major bleeding, which requires relatively rapid improvement of thrombocytopenia.

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Condition tags

endometriosis

MeSH descriptors

Benzoates Hemorrhage Hydrazines Leukemia, Lymphocytic, Chronic, B-Cell Lung Diseases Pyrazoles Thrombocytopenia Thrombocytopenia Adrenal Cortex Hormones Adrenal Cortex Hormones Aged Antibodies, Monoclonal, Murine-Derived Antibodies, Monoclonal, Murine-Derived Benzoates Hemorrhage Hemorrhage Humans Hydrazines Immunoglobulins Immunoglobulins

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