Pb1889: A Case of Refractory Chronic Lymphocytic Leukemia Induced Immune Thrombocytopenic Purpura Successfully Treated With Venetoclax

Yavuz, Boran; Yücel, Elçin Erdoğan; Seker, Ozlem; Güven, Sinan; Kakci, M.; Ozsan, G. H.; Alacacıoğlu, İnci; Demirkan, F.

doi:10.1097/01.hs9.0000850408.37394.79

Cited by 2 publications

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“…Three case reports have documented the use of venetoclax in CLL-associated ITP (11)(12)(13). Similar to the cases demonstrated here, in all three reports, the patients were refractory to multiple lines of treatment before attaining a response upon initiation of venetoclax, although one patient had received rituximab in combination and another relapsed 5 weeks after discontinuation of adjunctive prednisolone and romiplostim.…”

Section: Discussionsupporting

confidence: 78%

Case report: Successful treatment of refractory immune thrombocytopenia in chronic lymphocytic leukaemia with venetoclax monotherapy

Woo,

Carter,

Follows

et al. 2023

Front. Oncol.

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In chronic lymphocytic leukaemia (CLL), immune dysregulation is common and can manifest as immune thrombocytopenia (ITP). Corticosteroids are the mainstay for front-line management of CLL-associated ITP. Therapy refractoriness represents a clinical challenge and is an indication to commence CLL-directed treatment, historically with anti-CD20 antibody-based chemoimmunotherapy. There is a small but growing body of evidence supporting the use of Bruton’s tyrosine kinase (BTK) inhibitors in this setting, but not the B-cell lymphoma-2 inhibitor, venetoclax. Here, we describe two cases of refractory ITP in patients with CLL who successfully achieved and sustained complete remission with fixed-duration venetoclax monotherapy. Responses were rapid and durable and not explained by the concomitant use of an anti-CD20 antibody. This supports a dual role for single-agent venetoclax in managing active CLL and associated ITP as an alternative to BTK inhibitors and anti-CD20 monoclonals.

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Section: Discussionsupporting

confidence: 78%