Idiopathic thrombocytopenic purpura and myasthenia gravis after fludarabine treatment for chronic lymphocytic leukemia.
We report a patient with chronic lymphocytic leukemia (CLL) who developed idiopathic thrombocytopenic purpura (ITP) and myasthenia gravis (MG) after fludarabine therapy. ITP developed after 6 cycles of fludarabine treatment, and MG occurred 2 months after the onset of ITP. MG was successfully treated with immunosuppressive therapy and plasma exchange, while rituximab was effective for CLL and ITP. Fludarabine seemed to have an important role in the onset of ITP and MG in this case.
Fujimaki
Katsumichi
K
First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan. kfujimaki@cancer.livedoor.com
Takasaki
Hirotaka
H
Koharazawa
Hideyuki
H
Takabayashi
Maki
M
Yamaji
Satoshi
S
Baba
Yasuhisa
Y
Kanamori
Heiwa
H
Ishigatsubo
Yoshiaki
Y
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D000069283:Rituximab; D016879:Salvage Therapy; D016896:Treatment Outcome; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014740:Vidarabine; C024352:fludarabine