急性淋巴细胞白血病维持期的免疫性血小板减少性紫癜：一种罕见的并存情况，需要高度怀疑，病例报告及文献综述
Immune Thrombocytopenic Purpura During Maintenance Phase of Acute Lymphoblastic Leukemia: A Rare Coexistence Requiring a High Degree of Suspicion, a Case Report and Review of the Literature.
作者信息
Bayhan Turan, Ünal Şule, Gümrük Fatma, Çetin Mualla
机构信息
Hacettepe University Faculty of Medicine, Division of Pediatric Hematology, Ankara, Turkey Phone: +90 312 305 11 72 E-mail:
出版信息
Turk J Haematol. 2015 Dec;32(4):363-6. doi: 10.4274/tjh.2014.0138. Epub 2015 Apr 27.
Abstract
Thrombocytopenia may develop in patients with acute lymphoblastic leukemia (ALL) due to myelosuppression of chemotherapy or relapse. Here we report a pediatric patient with ALL whose platelet counts decreased at the 102nd week of maintenance treatment. Thrombocytopenia was refractory to platelet infusions and bone marrow aspiration revealed remission status for ALL along with increased megakaryocytes. The cessation of chemotherapy for 2 weeks caused no increase in thrombocyte counts. The viral serology was unrevealing. A diagnosis of immune thrombocytopenic purpura (ITP) was established. After administration of intravenous immunoglobulin, the thrombocytopenia resolved. When thrombocytopenia occurs in patients with ALL in remission, ITP should be kept in mind after exclusion of the more common etiologies.
摘要
急性淋巴细胞白血病（ALL）患者可能因化疗的骨髓抑制或复发而出现血小板减少。在此，我们报告一名ALL患儿，其在维持治疗的第102周血小板计数下降。血小板输注对血小板减少无效，骨髓穿刺显示ALL处于缓解状态，巨核细胞增多。化疗中断2周并未导致血小板计数增加。病毒血清学检查无异常。确诊为免疫性血小板减少性紫癜（ITP）。静脉注射免疫球蛋白后，血小板减少症得到缓解。当ALL缓解期患者出现血小板减少时，排除较常见病因后应考虑ITP。
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