Acquired pure red cell aplasia associated with chronic lymphocytic leukemia

Yoo, Dal; Pierce, Lawrence E.; Lessin, Lawrence S.

doi:10.1002/1097-0142(19830301)51:5<844::aid-cncr2820510517>3.0.co;2-t

Cited by 17 publications

(4 citation statements)

References 28 publications

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“…In our own studies where we did routinely perform BM studies, the diagnosis of ITP was made in 47% of patients with autoimmune cytopenia10. Pure red blood cell aplasia (PRBCA) is a much less common complication of CLL occurring in about 1% of patients and cases of autoimmune granulocytopenia are rare10,12,18,21. However it is important to recognize that autoimmune mechanisms can cause multilineage cytopenia in CLL patients and these are estimated to occur in approximately 12 – 17% of patients with autoimmune cytopenia10,17.…”

Section: Epidemiologymentioning

confidence: 99%

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Autoimmune Complications in Chronic Lymphocytic Leukaemia (CLL)

Zent

Kay

2010

Best Practice & Research Clinical Haematology

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Patients with B-chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have a 5–10% risk of developing autoimmune complications which primarily cause cytopenia. These autoimmune cytopenias can occur at any stage of CLL and do not have independent prognostic significance. The most common autoimmune complication is autoimmune hemolytic anemia with a lower frequency of immune thrombocytopenia and pure red blood cell aplasia and only rare patients with autoimmune granulocytopenia. Autoimmune cytopenia should always be considered in the differential diagnosis of cytopenia in patients with CLL. Patients with CLL can also have more than one form of autoimmune cytopenia which can occur together with bone marrow failure. Treatment is usually effective but rarely curative for autoimmune cytopenia complicating CLL. Optimal therapy will depend on a timely and accurate diagnosis of autoimmune cytopenia and should be individualized according to the severity of the cytopenia and the presence or absence of concomitant progressive CLL requiring therapy.

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Section: Epidemiologymentioning

confidence: 99%

“…PRBCA occurs less frequently than AIHA or ITP but is still an important diagnostic consideration in patients with CLL and anemia21. PRBCA is characterized by profound reticulocytopenia and normal bilirubin and LDH levels and should thus be easily distinguishable from AIHA.…”

Section: Clinical Featuresmentioning

confidence: 99%

Autoimmune Complications in Chronic Lymphocytic Leukaemia (CLL)

Zent

Kay

2010

Best Practice & Research Clinical Haematology

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“…Anemia in CLL/SLL can be due to PRBCA, an isolated failure of erythropoiesis, with reticulocytopenia and the absence of erythroid precursors in the bone marrow [3,8]. This complication of CLL/SLL, which has a prevalence of about 1%, is possibly caused by T-cell−mediated inhibition of erythroid precursors [3,4].…”

Section: Introductionmentioning

confidence: 99%

Autoimmune cytopenia does not predict poor prognosis in chronic lymphocytic leukemia/small lymphocytic lymphoma†

et al. 2003

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Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is characterized by an acquired immune defect that can cause autoimmune complications, including anemia and thrombocytopenia. We conducted an observational study of the epidemiology, clinical presentation and significance of autoimmune complications of CLL/SLL in 132 patients from a large population (>45,000 veterans), in which at least 90% of patients with CLL/SLL have been previously identified. Over a period of 12.5 years, 12 patients (9.1%) had autoimmune complications; of these, 6 (4.5%) had autoimmune hemolytic anemia (AIHA), 5 (3.8%) had immune thrombocytopenia (ITP), and 1 (0.8%) had pure red blood cell aplasia (PRBA). All 6 cases of AIHA had a positive direct immunoglobulin test for IgG and C3d. In 6 patients, CLL/SLL was an incidental finding at the time of presentation with autoimmune cytopenia. Nine out of 10 patients responded to immunosuppressive therapy, which was complicated by serious infection in 7 cases, one of which was fatal. The major cause of mortality in patients with autoimmune complications of CLL/SLL was secondary malignancy. Survival of patients with immune cytopenia was not significantly different from CLL/SLL patients without immune cytopenia. Among patients with anemia or thrombocytopenia, mortality was significantly higher in those with bone marrow failure compared to an autoimmune etiology. We show that in a non-referred population with a high incidence of CLL/SLL, autoimmune cytopenia can occur early in the natural history of the disease. These data suggest that the Rai and Binet classifications for CLL need to be modified for patients with autoimmune cytopenia. Am.

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“…W leczeniu PRCA, podobnie jak AIHA, proponuje się kortykoidy, leki immunosupresyjne i rytuksymab ewentualnie w skojarzeniu z cyklofosfamidem i deksametazonem. Nie ma natomiast jednoznacznie ustalonego sposobu postępowania w IN [31,46,47,50].…”

Section: Inne Powikłania Autoimmunologiczneunclassified

Powikłania infekcyjne i autoimmunologiczne w przewlekłej białaczce limfocytowej

Wołowiec

2013

Acta Haematologica Polonica

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Acquired pure red cell aplasia associated with chronic lymphocytic leukemia

Cited by 17 publications

References 28 publications

Autoimmune Complications in Chronic Lymphocytic Leukaemia (CLL)

Autoimmune Complications in Chronic Lymphocytic Leukaemia (CLL)

Autoimmune cytopenia does not predict poor prognosis in chronic lymphocytic leukemia/small lymphocytic lymphoma†

Powikłania infekcyjne i autoimmunologiczne w przewlekłej białaczce limfocytowej

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