Chronic lymphocytic leukemia-associated immune thrombocytopenia treated with rituximab: A retrospective study of 21 patients

Giovanni D'Arena, Silvana Capalbo, Luca Laurenti, Giovanni Del Poeta, Giuseppe Nunziata, Silvia Deaglio, Giuseppina Spinosa, Michela Tarnani, Laura De Padua, Catello Califano, Felicetto Ferrara, Nicola Cascavilla

Research output: Contribution to journalArticlepeer-review


Introduction: There are no standard therapies for chronic lymphocytic leukemia (CLL)-associated immune thrombocytopenia (IT) so far.Patients and 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.

Original languageEnglish
Pages (from-to)502-507
Number of pages6
JournalEuropean Journal of Haematology
Issue number6
Publication statusPublished - Dec 2010


  • Chronic lymphocytic leukemia
  • Immune thrombocytopenia
  • Rituximab

ASJC Scopus subject areas

  • Hematology


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