Forehand Iii William, Ajebo Germame, Toscano Michael, Jillella Anand, Dainer Paul
Division of Hematology-Oncology, Medical College of Georgia, Augusta University, Georgia Cancer Center, Augusta, Georgia.
Department of Pathology and Laboratory Medicine, Augusta University, Augusta, Georgia.
Case Rep Hematol. 2020 Nov 12;2020:8825618. doi: 10.1155/2020/8825618. eCollection 2020.
Lenalidomide is indicated in the front-line management of multiple myeloma. More recently, it has been introduced for use in treating other hematologic malignancies. Although the drug is known to cause myelosuppression, there have been rare reports of lenalidomide-associated immune thrombocytopenia (ITP). Here, we review the literature on lenalidomide-associated ITP and report upon a 59-year-old man who was administered lenalidomide due to concern of progressive multiple myeloma more than a year following his having undergone an autologous hematopoietic stem cell transplant. His platelet count precipitously declined and lead to his hospitalization. Despite our withholding of the drug, he did not respond to platelet transfusions or administration of corticosteroids. He was successfully managed with intermittent immune globulin for several months before definitive treatment with splenectomy, which resulted in the complete resolution of his thrombocytopenia. A literature search identified a total of six additional cases of lenalidomide-associated ITP. Similarly, many of the reported cases were associated with persistent thrombocytopenia after discontinuation of the drug. Furthermore, these patients were generally managed successfully with standard ITP therapies, such as corticosteroids or intravenous immune globulin.
来那度胺适用于多发性骨髓瘤的一线治疗。最近，它已被引入用于治疗其他血液系统恶性肿瘤。尽管已知该药物会引起骨髓抑制，但关于来那度胺相关免疫性血小板减少症（ITP）的报道却很少。在此，我们回顾了关于来那度胺相关ITP的文献，并报告了一名59岁男性，他在接受自体造血干细胞移植一年多后，因担心多发性骨髓瘤进展而来那度胺。他的血小板计数急剧下降并导致住院。尽管我们停用了该药物，但他对血小板输注或皮质类固醇治疗均无反应。在进行脾切除术的确定性治疗之前，他通过间歇性免疫球蛋白成功治疗了几个月，这导致他的血小板减少症完全缓解。文献检索总共发现了另外6例来那度胺相关ITP病例。同样，许多报告的病例在停药后仍伴有持续性血小板减少症。此外，这些患者通常通过标准的ITP疗法（如皮质类固醇或静脉注射免疫球蛋白）成功治疗。
