title: Chronic idiopathic thrombocytopenic purpura (ITP:) development of acute non-lymphocytic leukemia subsequent to treatment with cyclophosphamide.
abstract: Chronic idiopathic thrombocytopenic purpura (ITP) is most often treated successfully with steroids and/or splenectomy. In those who fail to respond with the foregoing treatment, immunosuppressive drugs are sometimes added to the regimen. Cyclophosphamide has been reported heretofore to be effective with a minimum of side effects and complications. However, the use of alkylating agents and the induction of a second malignancy is now well recognized. This report describes three cases of refractory ITP treated with cyclophosphamide who subsequently developed an acute non-lymphocytic leukemia. Cyclophosphamide should be used with discretion in the treatment of chronic idiopathic thrombocytopenic purpura which is a non-neoplastic disorder.
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003520:Cyclophosphamide / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011696:Purpura, Thrombocytopenic / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D013156:Splenectomy; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids; D003520:Cyclophosphamide