title: Autoimmune thrombocytopenia due to chronic lymphocytic leukemia treated with fludarabine.
abstract: OBJECTIVE
  To report a case of autoimmune thrombocytopenia due to chronic lymphocytic leukemia (CLL) treated with fludarabine.
  
  
  METHODS
  A 68-year-old white woman with CLL was treated with oral chlorambucil. She subsequently presented with severe autoimmune thrombocytopenia purpura (ITP). Intravenous gammaglobulin was administered without response, and a therapeutic splenectomy produced only a temporary response, with platelets reaching 65 x 10(3)/mm(3). Four weeks later, the platelet level was below 10 x 10(3)/mm(3). At that time, the woman was treated with fludarabine. The platelet count 4 weeks later was normal (270 x 10(3)/mm(3)) and has been sustained for over 22 months.
  
  
  CONCLUSIONS
  Fludarabine has been reported to be causative in the onset of autoimmune cytopenias with CLL. Our case cautiously suggests fludarabine as a potential treatment for cases of CLL-associated ITP refractory to standard therapy.
  
  
  CONCLUSIONS
  Fludarabine could be considered as treatment of ITP in CLL refractory to standard treatment.
authors.affiliation: University of Western Ontario, London, Ontario, Canada.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Wells
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kovacs
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002699:Chlorambucil / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy*; D013997:Time Factors; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D002699:Chlorambucil; D014740:Vidarabine; C024352:fludarabine