Autoimmune thrombocytopenia: a complication of fludarabine therapy in lymphoproliferative disorders.
We describe two cases of autoimmune thrombocytopenia precipitated by fludarabine therapy in patients with chronic lymphatic leukaemia. Both were treated with high dose steroids and initially responded with recovery of normal platelet counts. One patient developed recurrent autoimmune thrombocytopenia on two occasions following re-exposure to the drug when his disease had become refractory to all other treatments. A retrospective review of the case notes of 45 patients with lymphoproliferative disorders treated with fludarabine over the past 6 years indicated the development of autoimmune thrombocytopenia in 4.5% (two out of 45) and autoimmune haemolytic anaemia in 6.7% (three of the 45).
Department of Haematology, Stobhill Hospital, Glasgow, UK. mike.leach@northglasgow.scot.nhs.uk
M
M
Leach
R M
RM
Parsons
J T
JT
Reilly
D A
DA
Winfield
D000328:Adult; D000368:Aged; D000743:Anemia, Hemolytic / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000188:drug therapy; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced*; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D014740:Vidarabine; C024352:fludarabine