Refractory chronic immune thrombocytopenic purpura in a child with acute lymphoblastic leukemia.
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.
Horino
Satoshi
S
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.
Rikiishi
Takeshi
T
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Niizuma
Hidetaka
H
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Abe
Hiroshi
H
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Watanabe
Yuko
Y
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Onuma
Masaei
M
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Hoshi
Yoshiyuki
Y
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Sasahara
Yoji
Y
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Yoshinari
Miyako
M
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Kazama
Takuro
T
Department of Pediatric Surgery, School of Medicine, Tohoku University Hospital, Tohoku University, Sendai, Japan.
Hayashi
Yutaka
Y
Department of Pediatric Surgery, School of Medicine, Tohoku University Hospital, Tohoku University, Sendai, Japan.
Kumaki
Satoru
S
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
Tsuchiya
Shigeru
S
Department of Pediatrics, School of Medicine, Tohoku University Hospital, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan.
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