Lai Chow Yee, Pettit Tristan
Children's Haematology and Oncology Centre, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
J Pediatr Hematol Oncol. 2019 Nov;41(8):620-623. doi: 10.1097/MPH.0000000000001243.
In this report, we present a young infant with multisystem Langerhans cell histiocytosis, who after cladribine and cytarabine salvage treatment developed immune thrombocytopenia (IT). On review of the literature, there were no previous reports of Langerhans cell histiocytosis-associated IT. Treatment of the IT with intravenous immunoglobulin and oral corticosteroids was unsuccessful. Eltrombopag, in combination with a 4-day course of dexamethasone was commenced as second-line therapy. Platelet recovery occurred 10 days after initiation of eltrombopag. The immune thrombocytopenia remains in long-term remission despite cessation of eltrombopag. Eltrombopag was safe and well tolerated.
在本报告中，我们介绍了一名患有多系统朗格汉斯细胞组织细胞增多症的幼儿，其在接受克拉屈滨和阿糖胞苷挽救治疗后出现了免疫性血小板减少症（IT）。经文献检索，此前尚无朗格汉斯细胞组织细胞增多症相关IT的报道。用静脉注射免疫球蛋白和口服糖皮质激素治疗IT未获成功。作为二线治疗，开始使用艾曲泊帕联合4天疗程的地塞米松。开始使用艾曲泊帕10天后血小板恢复。尽管停用了艾曲泊帕，但免疫性血小板减少症仍长期缓解。艾曲泊帕安全且耐受性良好。
