Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Medicina (Kaunas). 2021 Dec 3;57(12):1326. doi: 10.3390/medicina57121326.
The occurrence of chronic myeloid leukemia (CML), or other myeloproliferative diseases, after the development of idiopathic thrombocytopenic purpura (ITP) is very rare in the current medical literature. Considering the advances in ITP management, and the wide use of new drugs for ITP and CML, we report an unusual case with this association. Our case report focused on a 64-year-old man with long-standing ITP treated with eltrombopag, who developed hyperleukocytosis during follow-up; after specific laboratory exams, it was diagnosed as CML and he began treatment with imatinib. The treatment with eltrombopag was balanced with imatinib to stabilize his platelet count. Data on bcr-abl and JAK2 transcripts were collected and revealed an optimal response with the achievement of negativization of both molecular signatures. We could demonstrate that treatment with imatinib and eltrombopag was well tolerated and allowed complete molecular remission of CML to be achieved, as well as of ITP.
在当前的医学文献中，特发性血小板减少性紫癜（ITP）发展后出现慢性髓性白血病（CML）或其他骨髓增生性疾病非常罕见。考虑到 ITP 管理的进展，以及新的 ITP 和 CML 药物的广泛使用，我们报告了一例具有这种关联的不寻常病例。我们的病例报告主要集中在一位 64 岁的男性，他患有长期 ITP，接受了艾曲波帕治疗，在随访期间出现白细胞增多；经过特定的实验室检查，被诊断为 CML，并开始接受伊马替尼治疗。艾曲波帕的治疗与伊马替尼平衡，以稳定他的血小板计数。收集了 bcr-abl 和 JAK2 转录本的数据，结果显示达到了两种分子特征的阴性化，实现了最佳反应。我们能够证明，伊马替尼和艾曲波帕的治疗耐受性良好，并且能够实现 CML 和 ITP 的完全分子缓解。
