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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1110-1116. Prepublished online as a Blood First Edition Paper on November 6, 2007; DOI 10.1182/blood-2007-09-111492. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-09-111492v1 111/3/1110    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Visco, C. Articles by Rodeghiero, F. Search for Related Content PubMed PubMed Citation Articles by Visco, C. Articles by Rodeghiero, F. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Impact of immune thrombocytopenia on the clinical course of chronic lymphocytic leukemia Carlo Visco1, Marco Ruggeri1, Maria Laura Evangelista2, Roberto Stasi2, Roberta Zanotti3, Ilaria Giaretta1, Achille Ambrosetti3, Domenico Madeo1, Giovanni Pizzolo3, and Francesco Rodeghiero1 1 Department of Hematology, Ospedale San Bortolo, Vicenza; 2 Department of Medical Sciences, Ospedale Regina Apostolorum, Albano Laziale; and 3 Department of Clinical and Experimental Medicine, Section of Hematology, University of Verona, Verona, Italy The prevalence, clinical characteristics, and prognostic significance of immune thrombocytopenia (IT) in patients with chronic lymphocytic leukemia (CLL) have not been clearly determined. To clarify this, we retrospectively analyzed 1278 consecutive newly diagnosed patients with CLL. Criteria for IT diagnosis included the following: rapid (< 2 weeks) and severe fall (half of the initial level and below 100 x 109/L) in platelet count; normal or augmented megakaryocytes in bone marrow; no or limited (not palpable) splenomegaly; no cytotoxic treatment in the preceding month. Sixty-four patients (5%) were diagnosed with IT. The median time to IT from CLL diagnosis was 13 months (range, 0-81 months), and median platelet count at IT diagnosis was 14 x 109/L (range, 1-71 x 109/L). Fifty-six of the 64 patients (87%) received treatment for IT. The probability of responding to treatment for IT was significantly higher for patients receiving chemotherapy with or without steroids than for patients treated with intravenous immunoglobulins with or without steroids (P = .01). The development of IT was significantly associated with unmutated IgVh, a positive direct antiglobulin test, and the occurrence of autoimmune hemolytic anemia. Patients with CLL and IT had poorer survival than other patients with CLL (5-year overall survival 64% vs 82%, P < .001), and this effect was independent from common clinical prognostic variables. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. B. Cines, J. B. Bussel, H. A. Liebman, and E. T. Luning Prak The ITP syndrome: pathogenic and clinical diversity Blood, June 25, 2009; 113(26): 6511 - 6521. [Abstract] [Full Text] [PDF] F. Rodeghiero, R. Stasi, T. Gernsheimer, M. Michel, D. Provan, D. M. Arnold, J. B. Bussel, D. B. Cines, B. H. Chong, N. Cooper, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group Blood, March 12, 2009; 113(11): 2386 - 2393. [Abstract] [Full Text] [PDF] K. Vanura, T. Le, H. Esterbauer, F. Spath, E. Porpaczy, M. Shehata, K. Eigenberger, A. Hauswirth, C. Skrabs, E. Kromer, et al. Autoimmune conditions and chronic infections in chronic lymphocytic leukemia patients at diagnosis are associated with unmutated IgVH genes Haematologica, December 1, 2008; 93(12): 1912 - 1916. [Abstract] [Full Text] [PDF] C. Dearden Disease-Specific Complications of Chronic Lymphocytic Leukemia Hematology, January 1, 2008; 2008(1): 450 - 456. [Abstract] [Full Text] [PDF]

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