title: Refractory chronic immune thrombocytopenic purpura in a child with acute lymphoblastic leukemia.
abstract: Immune thrombocytopenic purpura (ITP) has been associated with several hematologic malignancies such as Hodgkin and non-Hodgkin lymphomas and chronic lymphocytic leukemia, but it is rare in children with acute lymphoblastic leukemia (ALL). Here, we report a 7-year-old girl with chronic ITP during early intensive phase of chemotherapy for ALL. She underwent splenectomy because thrombocytopenia had persisted even after treatment with intravenous immunoglobulin (IVIG), steroids, vincristine, rituximab, and anti-D antibody. After splenectomy, her platelet count had recovered, and maintenance therapy could be resumed with a support of IVIG. To our knowledge, this is the first child case of chronic ITP during chemotherapy for ALL and splenectomy was effective in this patient.
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan. horino-thk@umin.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Horino
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Rikiishi
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Niizuma
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Masaei
authors.initials: M
authors.lastname: Onuma
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hoshi
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Sasahara
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Miyako
authors.initials: M
authors.lastname: Yoshinari
authors.affiliation: Department of Pediatric Surgery, School of Medicine, Tohoku University Hospital, Tohoku University, Sendai, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Kazama
authors.affiliation: Department of Pediatric Surgery, School of Medicine, Tohoku University Hospital, Tohoku University, Sendai, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kumaki
authors.affiliation: Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tsuchiya
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy / Q000601:surgery*; D013156:Splenectomy; D016896:Treatment Outcome