Autoimmune pancytopenia following combination chemotherapy for chronic lymphocytic leukaemia.
Autoimmune haemolysis or thrombocytopenia can complicate purine nucleoside monotherapy for chronic lymphocytic leukaemia (CLL), but Evans syndrome is rare. This is a report of the occurrence of pancytopenia secondary to a unique combination of red cell aplasia with autoimmune thrombocytopenia and neutropenia in a patient with CLL following treatment with fludarabine and cyclophosphamide. This case is unusual for the simultaneous targeting of three haemopoietic lineages by immune dysfunction following fludarabine and cyclophosphamide, which is a treatment regimen believed to reduce autoimmune haematological toxicity in CLL.
MacCallum
S
S
Centre for Oncology and Molecular Medicine, Division of Medical Sciences, University of Dundee, Dundee, Scotland, UK.
Groves
M
M
Brass
D
D
Cunningham
J
J
Sales
M
M
Gelly
K
K
Tauro
S
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000139:chemically induced*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000139:chemically induced*; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine