Autoimmune thrombocytopenia: A complication of fludarabine therapy in lymphoproliferative disorders

• Published in: Clinical and laboratory haematology 2000-06, Vol.22 (3), p.175-178
• Main Authors: Leach, M., Parsons, R.M., Reilly, J.T., Winfield, D.A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anemia, Hemolytic - chemically induced; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Autoimmune thrombocytopenia; Biological and medical sciences; Drug toxicity and drugs side effects treatment; fludarbine; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Leukemia, Lymphocytic, Chronic, B-Cell - complications; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; lymphoproliferative disorders; Lymphoproliferative Disorders - complications; Lymphoproliferative Disorders - drug therapy; Male; Medical sciences; Pharmacology. Drug treatments; Purpura, Thrombocytopenic, Idiopathic - chemically induced; Toxicity: blood; Vidarabine - adverse effects; Vidarabine - analogs & derivatives; Vidarabine - therapeutic use
• ISSN: 0141-9854; 1365-2257
• DOI: 10.1046/j.1365-2257.2000.00305.x

Summary We describe two cases of autoimmune thrombocytopenia precipitated by fludarabine therapy in patients with chronic lymphatic leukaemia. Both were treated with high dose steroids and initially responded with recovery of normal platelet counts. One patient developed recurrent autoimmune thrombocytopenia on two occasions following re‐exposure to the drug when his disease had become refractory to all other treatments. A retrospective review of the case notes of 45 patients with lymphoproliferative disorders treated with fludarabine over the past 6 years indicated the development of autoimmune thrombocytopenia in 4.5% (two out of 45) and autoimmune haemolytic anaemia in 6.7% (three of the 45).