Autoimmune thrombocytopenia in non-Hodgkin's lymphomas

Abstract

Autoimmune thrombocytopenia is a common immune-hematologic complication in non-Hodgkin's lymphomas and may complicate the treatment. We analyzed an original series from our institute as well as published cases of non-Hodgkin's lymphomas (excluding chronic lymphocytic leukemia) associated with autoimmune thrombocytopenia with regard to demographic factors, prevalence in nonHodgkin's lymphoma subtypes and treatment outcome. The male/female ratio is 1.75. Half of the cases occurred prior to diagnosis of lymphoma. Chemotherapy is the best treatment in many non-Hodgkin's lymphomas patients with autoimmune thrombocytopenia compared with standard treatment of autoimmune thrombocytopenia. Splenectomy is effective in splenic marginal zone lymphoma. Autoimmune thrombocytopenia in patients with non-Hodgkin's lymphomas is potentially life-threatening and difficult to treat.

Long-term clinical outcomes of patients with primary chronic immune thrombocytopenia: a Danish population-based cohort study

“…Alternatively, because chronic ITP is a diagnosis of exclusion, immune thrombocytopenia may represent the initial stage of hematologic malignancy. 23,24 In the US study, 10 in which the adjusted IRR for leukemia was 19.83 (95% CI, 5.84-67.34), 5 of 18 leukemia diagnoses occurred within 1-2 months after the chronic ITP diagnosis. Therefore, the investigators found it probable that some patients were misdiagnosed with ITP in the early stages of their cancer diagnosis.…”

Safety and efficacy of eltrombopag for treatment of chronic immune thrombocytopenia: results of the long-term, open-label EXTEND study

“…[39][40][41] Thrombocytopenia can be the first indication of a hematologic malignancy and may precede its onset by years. Theoretically, stimulation of the TPO-R on hematopoietic cells may increase the risk of hematologic malignancies.…”

Immune thrombocytopenic purpura occurred prior to multiple extranodal diffuse large B cell lymphoma

“…Only one case responded well to the prednisone and cyclophosphamide [6], while the others had partial or no responses to the treatment for ITP. More than half of the ITP patients achieved complete remission after anti-lymphoma treatment [2]. In some patients with ITP, rituximab has been associated with a reduction in specific platelet autoantibodies and an increase in platelet count [12].…”

“…Some papers have reviewed immune thrombocytopenic purpura (ITP) associated with lymphoma [1,2]. The prevalence of ITP was more common in chronic lymphocytic leukemia/small cell lymphocytic lymphoma (CLL/SLL) and hodgkin's disease (HD) than in non-hodgkin's lymphoma (NHL) without CLL [1].…”