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: Satoshi Horino, Takeshi Rikiishi, Hidetaka Niizuma, Hiroshi Abe, Yuko Watanabe, Masaei Onuma, Yoshiyuki Hoshi, Yoji Sasahara, Miyako Yoshinari, Takuro Kazama, Yutaka Hayashi, Satoru Kumaki, Shigeru Tsuchiya
• Journal: International journal of hematology (Int J Hematol) Vol. 90 Issue 4 Pg. 483-485 (Nov 2009) ISSN: 1865-3774 [Electronic] Japan
• PMID: 19816666 (Publication Type: Case Reports, Journal Article)

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Child
• Chronic Disease
• Female
• Humans
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications, drug therapy)
• Purpura, Thrombocytopenic, Idiopathic (complications, drug therapy, surgery)
• Splenectomy
• Treatment Outcome