Management of autoimmune cytopenia complicating chronic lymphocytic leukemia.

摘要

Autoimmune cytopenia is an important and often serious complication of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL). The most common presentations are autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), with a lower frequency of pure red blood cell aplasia (PRBCA), and only rare patients who have autoimmune granulocytopenia [1]. The earlier and accurate diagnosis of CLL together with improvements in treatment have altered the presentation and prevalence of autoimmune cytopenia in patients with CLL and recent studies have reported a cumulative risk of approximately 5-10% [1-3]. Autoimmune cytopenia can complicate all clinical stages of CLL and can also be precipitated by treatment with both purine analogues and alkylating agents [4].