title: Chronic lymphocytic leukemia-associated immune thrombocytopenia treated with rituximab: a retrospective study of 21 patients.
abstract: BACKGROUND
  There are no standard therapies for chronic lymphocytic leukemia (CLL)-associated immune thrombocytopenia (IT) so far.
  
  
  METHODS
  We report the results of therapy with single agent rituximab in 21 patients with CLL-associated IT. The mean age at CLL and IT diagnosis was 64 and 68 yr, respectively. IT developed at a mean time of 44 months from the diagnosis of CLL. In four cases, IT was diagnosed at the same time as CLL. For three patients, IT was considered fludarabine-related and two patients showed autoimmune hemolysis also. All patients but one received steroids as first-line treatment for IT. Some patients received intravenous high-dose Ig, vincristine, and Cytoxan also, without beneficial effect. After a mean time of 43 d from the diagnosis of IT, all patients were scheduled to receive rituximab at a dosage of 375 mg/mq/weekly.
  
  
  RESULTS
  Eighteen (86%) patients completed the scheduled four cycles of rituximab. Irrelevant first infusion side effects were seen only in one patient. Twelve (57%) patients showed a complete response (CR), six (29%) patients a partial response (PR), and three (14%) patients did not respond. In responding patients, the mean duration of response was 21 months (4-49 months). At a mean follow-up of 28 months, 14 (66%) patients were still alive, 10 (48%) of them in CR and three (14%) in PR.
  
  
  CONCLUSIONS
  This retrospective analysis prove that rituximab is an effective and well-tolerated alternative treatment for CLL-associated IT.
authors.affiliation: Hematology and Stem Cell Transplantation Unit, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy. giovannidarena@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Arena
authors.forename: Silvana
authors.initials: S
authors.lastname: Capalbo
authors.forename: Luca
authors.initials: L
authors.lastname: Laurenti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nunziata
authors.forename: Silvia
authors.initials: S
authors.lastname: Deaglio
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Spinosa
authors.forename: Michela
authors.initials: M
authors.lastname: Tarnani
authors.forename: Laura
authors.initials: L
authors.lastname: De Padua
authors.forename: Catello
authors.initials: C
authors.lastname: Califano
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Nicola
authors.initials: N
authors.lastname: Cascavilla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab